History Of Infectious Diseases Research Articles

Modeling for Prediction of Mortality Based on past Medical History in Hospitalized COVID‐19 Patients: A Secondary Analysis

Introduction. Although COVID‐19 is not currently a public health emergency, it will affect susceptible individuals in the post‐COVID‐19 era. Hence, the present study aimed to develop a model for Iranian patients to identify at‐risk groups based on past medical history (PMHx) and some other factors affecting the death of patients hospitalized with COVID‐19. Methods. A secondary study was conducted with the existing data of hospitalized COVID‐19 adult patients in the hospitals covered by Iran University of Medical Sciences. PMHx was extracted from the registered ICD‐10 codes. Stepwise logistic regression was used to predict mortality by PMHx and background covariates such as intensive care unit (ICU) admission. Crude population attributable fraction (PAF) as well as crude and adjusted odds ratio (OR) with 95% confidence interval (CI) were reported. Results. A total of 8879 patients were selected with 19.68% mortality. Infectious and parasitic diseases’ history showed the greatest association (OR = 5.72, 95% CI: 4.20, 7.82), while the greatest PAF was for cardiovascular system diseases (20.46%). According to logistic regression modeling, the largest effect, other than ICU admission and age, was for history of infectious and parasitic diseases (OR = 3.089, 95% CI: 2.13, 4.47). A good performance was achieved (area under curve = 0.875). Conclusion. Considering the prevalence of underlying diseases, many mortality cases of COVID‐19 are attributable to the history of cardiovascular disease. Future studies are needed for policy making regarding reduction of COVID‐19 mortality in susceptible groups in the post‐COVID‐19 era.

History of Infectious Diseases in Toddlers and Frequency of Community Health Center Nutrition Services with Stunting Incidents

Toddlers are an important period in the process of growth and development of a child. Malnourished children can experience malnutrition and this can result in stunting. Stunting incidents could have a negative impact on the growth and development period of toddlers. There were several factors that influenced the incidence of stunting, both directly and indirectly. Stunting was still a serious health problem facing Indonesia. This study aims to analyze the relationship between the history of infectious diseases and the frequency of community health centre nutrition services with the incidence of stunting. The research design was cross-sectional with a stratified simple random sampling technique taken from 8 posyandu (Integrated Healthcare Center) with a total sample of 112 toddlers. This research was conducted in the work area of the Saritani Community Health Center, Boalemo Regency, Gorontalo Province, from January to February 2023. The data analysis technique used in this research was the Chi-Square test. The results of the study showed that there was a significant relationship between the history of infectious diseases in toddlers and the incidence of stunting (p value=0.006; p-value ≤ α = 0.05), OR value=2.804 and there was a significant relationship between the frequency of health centre nutrition services and the incidence of stunting ( p value=0.001; p-value ≤ α = 0.05), OR value=2.859 in the working area of the Saritani Health Center, Boalemo Regency. Nurses can carry out health promotion efforts for mothers of toddlers to increase stunting prevention by knowing the factors that cause stunting. Increase efforts to provide nutritional education services related to stunting at community health centres, namely the First 1000 Days of Life, Infant and Child Feeding Practices, and routine exclusive breastfeeding.

Does a prior diagnosis of infectious disease confer an increased risk of latent autoimmune diabetes in adults?

Infections are proposed risk factors for type 1 diabetes in children. We examined whether a diagnosis of infectious disease also confers an increased risk of latent autoimmune diabetes in adults (LADA). We used data from a population-based Swedish case-control study with incident cases of LADA (n=597) and matched controls (n=2386). The history of infectious disease was ascertained through national and regional patient registers. We estimated adjusted odds ratios (OR) with 95% confidence intervals for ≥1 respiratory (any/upper/lower), gastrointestinal, herpetic, other or any infectious disease episode, or separately, for 1 and ≥2 infectious disease episodes, within 0-1, 1-3, 3-5 and 5-10years before LADA diagnosis/matching. Stratified analyses were performed on the basis of HLA risk genotypes and Glutamic acid decarboxylase antibodies (GADA) levels. Individuals who developed LADA did not have a higher prevalence of infectious disease 1-10years before diabetes diagnosis. For example, OR was estimated at 0.87 (0.66, 1.14) for any versus no respiratory infectious disease within 1-3years. Similar results were seen for LADA with high-risk HLA genotypes (OR 0.95 [0.64, 1.42]) or high GADA levels (OR 1.10 [0.79, 1.55]), ≥2 episodes (OR 0.89 [0.56, 1.40]), and in infections treated using antibiotics (OR 1.03 [0.73, 1.45]). The only significant association was observed with lower respiratory disease the year preceding LADA diagnosis (OR 1.67 [1.06, 2.64]). Our findings do not support the idea that exposure to infections increases the risk of LADA. A higher prevalence of respiratory infection in the year before LADA diagnosis could reflect increased susceptibility to infections due to hyperglycemia.

History of infections is associated with smaller hippocampal volume in older women

AbstractBackgroundAccumulating evidence suggests that infections can play a major role in Alzheimer’s disease (AD), however, mechanism is unclear as multiple pathways may be involved. One possibility is that infections might contribute to AD directly by promoting neuronal death and neurodegeneration.MethodWe investigated the relationship between history of infectious diseases (a potential AD risk factor) and brain hippocampal volume, HV (a biomarker of neurodegeneration and AD neuropathology) in a subsample of the UK Biobank participants with respective information. Infectious disease diagnoses were based on ICD‐10 codes. The left/right HV was measured by the MRI. Analysis of variance (ANOVA) and Welch Two Sample t‐test were used to examine the statistical significance.ResultThe HV was significantly lower in older women (age 65+) with prior history of infections, compared to the same age women without such history (p‐value = 0.014 and 0.029, for the left and right HV, respectively). The effect size increased with age, and this increase was faster for the right vs. left HV. The difference in HV between male subjects with and without history of infections was not statistically significant.ConclusionIn this study, prior infections were significantly associated with the lower left/right HV in women aged 65+, which supports the role of infectious diseases in neurodegeneration and preclinical AD pathology in females. The effect size increased with age, in line with the increase in brain vulnerability to stressors due to aging. The faster increase for the right vs. left HV might indicate that females’ verbal memory declines faster with age compared to visual‐spatial memory, following the exposure to infectious disease, which deserves further investigation. The observed sex differences may reflect a higher vulnerability of the female brain to infection‐related factors, which in turn might contribute to the higher risk of AD in women compared to men.

Quality of life and factors associated among caregivers of adolescent and young adult Ebola survivors in Democratic Republic of the Congo, a cross-sectional study

BackgroundEbola virus disease is a medical condition whose consequent effects on quality of life of patients. In the history of infectious diseases, there have been pathologies that have had significant repercussions for caregivers, healthcare providers and the community.ObjectivesThis study investigate determinants of quality of life among caregivers of adolescent and young adult Ebola survivors in Democratic Republic of the Congo.MethodsThis was a cross sectional study. The study sites were the two health districts of Beni and Katwa, in North-Kivu province in the Eastern part of Democratic Republic of the Congo. The study period was from April to August 2022. Participants of the study were caregivers of adolescents and young adult Ebola virus survivors. Simple random sampling technique was used to select the 68 study participants. A questionnaire was administered. Data was collected using pretested questionnaire of WHO quality of life Bref (WHOQOL-BREF) and CommCare by Dimagi.Inc. lastest Version 2.52.1 and a sum of score of 78 or higher indicated a high level of life quality. To determine the quality of life of caregivers of adolescents and young adult EVD survivors, descriptive analysis was used. The Pearson correlation coefficient was utilized to check whether the predictor variables are multicollinear. The regression analysis produced the crude odds ratio (COR), adjusted odds ratio (aOR), 95% confidence interval (CI), and p-value. Statistical significance was defined as a p-value 0.05. The final multivariate model contained variables that were significant in the bivariate analysis. Prior to data collection, a research permit from National Ethical Committee of Research in Democratic Republic of the Congo was obtained. Written informed consents from literate or illiterate caregivers of adolescent and young adult Ebola survivors were obtained. Throughout the study, participants' privacy and confidentiality were respected.ResultsA total of 68 care givers participated in the study, with a majority 54/68(79.41%) having poor quality of life. Men were 3.17 times more likely to record good quality of life than women (p = 0.02); OR:(95% CI), 3.17: (1.2 – 8.36), With regards to place of residence, caregivers who lived in town were less likely to have good quality of life compared to those in rural (p = 0.01); OR: (95%CI), 0.25: (0.09 – 0.72).ConclusionThe quality of life of caregivers of adolescent and young adult Ebola survivors in Democratic Republic of the Congo is poor. To be woman caregiver and to live in town are determinants associated with poor quality of life among caregivers of adolescent and young adult Ebola survivors.

Applying Artificial Intelligence Machine Learning to Discover Factors That Shorten Duration of Treatment in Patients with Multiple Myeloma Using Real-World Patient-Level Longitudinal Data from Medical Data Vision Database

Introduction: To maximize the benefit of treatment in multiple myeloma (MM), it is important to continue treatment for appropriate duration . Our recent real-world study using the Medical Data Vision (MDV) claim database showed that median duration of treatment (DoT) of 1 line (L), 2L and 3L treatment was rather short (range: 6.7 to 8.6 months) in Japanese non-transplant patients with MM (Handa H, et al. Plos one. 2023). However, the broad range of treatment patterns in Japan makes it difficult to identify the cause of shortened DoT. Therefore, we assessed the predictive factors that shorten DoT at threshold of <3, <6 and <12 months by applying machine learning (ML) model using real-world clinical data of MM patients from the MDV database. Methods: This retrospective cohort study was conducted on 4848 individual treatments (2,762 patients; 1L for stem cell transplant-not conducted, 2L/3L) in patients (aged ≥18 years) with transplant-ineligible (newly diagnosed or relapsed/refractory) MM between 2003-21. An explainable deep learning model (point-wise linear model, PWL) was developed using 647 feature variables (evaluated before, during, and after treatment; Table) from the MDV database to identify the important predictors associated with DoT. The PWL model generated a custom-made logistic regression model for each sample, which was very familiar to medical researchers and allowed to analyze the importance of the feature variables. Predictive performance of the PWL model was compared with elastic-net regularized logistic regression and XGBoost models and calculated by area under the curve (AUC) and evaluated by 10-fold double cross validation. To stratify the patients with shorter DoT, a clustering analysis of 4848 individual treatment was conducted based on the similarity of coefficients of the custom-made logistic regression models generated from the PWL model. To understand characteristics of samples belonging to each cluster, the relationship between predicted DoT and MM treatment-related comorbidity management was investigated ( Table). Results: The AUC score of the PWL model to predict DoT of <3, <6 and <12 months was 0.61, 0.64 and 0.66, respectively ( Figure). As per clustering analysis, there were 2 clusters (cluster A and B) at DoT of <3 months and 3 clusters (cluster A, B and C) each at DoT of <6 and <12 months, respectively. At <3 months, cluster B showed lower median of prediction probability, and had a significantly (P<0.01) higher previous treatment lines, pre-treatment Charlson Comorbidity Index (CCI) versus cluster A. At <6 months, cluster C showed lower median of prediction probability, and had significantly (P<0.01) higher CCI and comorbidities, and cluster B had significantly (P<0.01) lower estimated glomerular filtration rate, among the clusters. At <12 months, cluster C showed lower median of prediction probability, and had significantly (P<0.01) higher lactate dehydrogenase (LD), previous treatment lines, pre-treatment CCI, degree of care requirement at diagnosis of MM, pre-treatment tube and parenteral nutrition, and comorbidities, among clusters. Additionally, in cluster B (at <3 months), and cluster C (at <6 and <12 months), use of immunomodulatory drugs (IMiDs) in treatment for MM was significantly higher in patients who met predicted DoT at each threshold versus the ones who were not. However, age and history of infectious diseases (antibacterial agents, γ globulin, etc.) was not affected. In addition, IMiDs and aspirin use at <3 and <6 months, and IMiDs use at <12 months had significant differences in events during and after treatment, which are important for considering treatment strategies for MM patients and may lead to the optimization of treatment plans. Study limitation included exclusion of important prognostic factors (cytogenetic profile, R-ISS stage, and presence of all plasmacytomas). Conclusions: TheML technique with PWL model yielded efficient results to understand the trend associated with event in treatment and characteristics of Japanese patients with MM whose DoT were shortened. Patient's condition and management related factors might have associated with shortened DoT, in consistent with clinical findings. These results are critical to continually improving MM management, achieving optimal patients care, and understanding the burden of disease and health services available to Japanese patients with MM in the real-world.

Analysis of Prevention, Detection, and Response Measures of Major Infectious Diseases by Modern Chinese Seaport Quarantine Institutions: A Case Study of Modern Tianjin Seaport Quarantine

During the late Qing Dynasty, Tianjin Customs gradually established the seaport quarantine system to prevent the spread of epidemics from Japan, Hong Kong, and the Northeast. The major infectious diseases inspected by the quarantine institution of Tianjin Port include cholera, plague, smallpox, typhus and yellow fever, of which cholera is the most frequent and influential infectious disease in modern Tianjin, followed by plague and smallpox, and no large-scale epidemics of typhus and yellow fever have been found.In the process of preventing the spreading of foreign infectious diseases, the quarantine institution of Tianjin Port has gradually developing. A set of business system has been established, which is based on ship inspection and takes preventive injection, rat flea research and disease diagnosis and treatment as the core.In conclusion,the seaport quarantine institutions in Tianjin played an active role in the prevention, detection, and response to major infectious diseases ,opened up a precedent for Chinese people to independently handle border health quarantine.Its historical practice and quarantine mode are a window for understanding the development history of quarantine infectious diseases in modern China, which has very important reference value.

Path analysis model for preventing stunting in dryland area island East Nusa Tenggara Province, Indonesia.

The problem of stunting is still a fundamental problem in Indonesia's human development. East Nusa Tenggara Province is an archipelago dryland area where in 2007-2021 it has contributed to the highest number of stunting children prevalence in Indonesia. This study aims to determine the relationship of variables in individual, household and district level with the prevalence of stunting. This type of research is observational study with a cross sectional design. This study used individual secondary data from the Indonesian Nutritional Status Survey in 2021 consisting of 7,835 toddlers and National Social Economics Survey 2021. This research found that both specific & sensitive intervention programs had an influence in accelerating the decline in stunting prevalence (higher score on Z Score). Results also revealed the positive influence of the food access variable on nutritional intake. The results of the path analysis test showed that sensitive intervention program variables have a positive effect on food access variable and environmental variable (environmental sanitation) such as the habit of open defecation and healthcare. There was significant relationship on disease history, environment and intake to Height for Age (HAZ) score. In conclusion, direct and indirect factors have important roles to prevent stunting. Sensitive and specific intervention program, food access, macro determinants and environment are the indirect indicators which contribute significantly to the stunting. The risk of children under five years old experiencing malnourished nutritional status increases with a history of infectious disease (diarrhea, ARI, worms). The risk of children under five years experiencing malnourished nutritional status decreases with adequate nutritional intake. It is hoped that there will be a special model of stunting control interventions at the individual level and at the family, household and district level that are integrated and of high quality through multisectoral cooperation in the dryland areas of the islands of East Nusa Tenggara Province.

Egypt as a Gateway for the Passage of Pathogens into the Ancient Mediterranean

Abstract Ancient Egypt plays a crucial role in the history of infectious disease. An intersection for communication and commerce, Egypt linked disparate civilizations and ecologies, allowing the spread of local epidemics and Mediterranean-wide pandemics. The region south of Egypt developed a pestilential reputation, due in part to Thucydides’ account of the Plague of Athens, which traced the disease’s origins to that area. Later records are modeled on Thucydides’ account, muddling the true origins and scope of later outbreaks. Critical reading of ancient literature and documents—particularly papyri—supplemented with archeological and palaeoscientific evidence, significantly improves our understanding of how Egypt facilitated the circulation of pathogens between the western Indian Ocean and the Mediterranean.

THE CORRELATION BETWEEN THE HISTORY OF EXCLUSIVE BREASTFEEDING, MACRONUTRIENT INTAKE, AND ZINC INTAKE IN CHILDREN AGE 6-59 MONTH AT KEJAJAR 2 HEALTH CENTER WONOSOBO

Stunting is a global health problem that needs attention. Wonosobo Regency has one of the highest stunting rates in Central Java at 15.97% and Kejajar 2 Health Centre has the 4th highest stunting prevalence in Wonosobo at 23.88% in February 2023. The causes of stunting are maternal factors, breastfeeding, inadequate supplementary food, and a history of chronic infectious diseases. This study aims to determine the relationship between exclusive breastfeeding, macronutrient intake, and zinc intake in children 6-59 months at Puskesmas Kejajar 2. This study uses a type of quantitative research with an analytical observational design and a case control approach. The research instruments used were KMS (Kartu Menuju Sehat), SQ-FFQ (Semi Quantitative-Food Frequency Quesionare) questionnaire, and microtoise or infantometer. The sampling technique was quota sampling with a total of 172 respondents, with a ratio of case and control groups 1: 1. The data analysis performed was univariate analysis and bivariate analysis with the Chi Square test. The results showed that exclusive breastfeeding did not show a significant relationship with the incidence of stunting with a p-value of 0.321 or p>0.05 and there was a relationship between protein, fat, carbohydrate, and zinc intake with the incidence of stunting with a p-value of 0.000 or p<0.05. So it can be concluded that exclusive breastfeeding has no significant relationship with the incidence of stunting, while macronutrient intake and zinc have a significant relationship with the incidence of stunting at Puskesmas Kejajar 2 Wonosobo.

Faktor Yang Berhubungan Dengan Status Gizi Balita (Bawah Lima Tahun) di Wilayah Kerja Puskesmas Naioni Kota Kupang

Inadequate Nutritional status of Children under five is still a public health issue in Kupang City. The purpose of this study was to analyze factors related to the nutritional status of toddlers (under five years) in the working area of ​​the Naioni Health Center, Kupang City. This study used an analytic observational method with a cross sectional study approach. The total sample of 93 people was selected using the cluster random sampling technique. The results of bivariate analysis using the chi-square test showed that there was a significant relationship between mother's knowledge and toddler nutritional status (p-value=0.024), mother's education (p-value=0.003), family income (p-value=0.005), exclusive breastfeeding (p-value=0.010), and a history of infectious diseases (p-value=0.019). Mother's knowledge is the most related factor to the nutritional status of toddlers. The variable that has no significant relationship is the mother's occupation (p-value = 0.138). Therefore the conclusion of this research is mother’s knowledge, mother’ level of health education, family income, and exclusive breast feeding are variables which have significant relationship with toddles nutritional status while mother’s occupation is a variable which has no relationship with toddler nutritional status in Naioni Health Centre. It is suggested to the health officer to increase health promotion about nutritional status to the community.

Faktor-faktor yang Mempengaruhi Kejadian Stunting pada Keluarga dengan Baduta

This research was conducted to analyze the factors that influence the incidence of stunting in families with children in the Kapuas River area according to the characteristics of the region and its population. This research uses a descriptive research method with a cross sectional approach to study the dynamics of the correlation between factors that influence stunting using an observational, data collection or approach. The research results obtained showed that the growth history factor with the incidence of stunting obtained a significance value of 0.091>0.05, the history of giving breast milk with the incidence of stunting obtained a significance value of 0.000<0.0, the history of giving MPASI with the incidence of stunting obtained a significance value of 0.071>0.05, family history with the incidence of stunting, a significance value was obtained of 0.019<0.05, a history of infectious disease with the incidence of stunting obtained a significance value of 0.084>0.05, and the mother's psychological pattern with the incidence of stunting obtained a significance value of 0.000<0.05. In conclusion, there is a significant relationship between the history of breastfeeding, family history and the incidence of stunting, and the psychological pattern of the mother and the incidence of stunting in influencing the incidence of stunting in families with toddlers in the Kapuas River suburbs.
 
 Keywords: Stunting Baduta, Family with Baduta, Stunting

The Knee Tenosynovial Giant Cell Tumor: A Deceptive Case Report with Non-Specific Presentations

Background: Tenosynovial giant cell tumor (TGCT) is a rare hyperplastic disease of the synovial membrane of the joint with a high recurrence rate and tumor-like features, affecting large joints such as the hip, knee, and ankle. Dull and chronic pain is common, as is swelling of the joint, which can make definitive diagnosis difficult. The gold standard of treatment is complete resection of the lesion. In this case report, we present a TGCT at the knee joint of an adult patient with nonspecific clinical presentation.
 Case Report: We present a 33-year-old male patient who presented with chronic swelling, warm sensation, and limited range of motion (ROM) in the knee. He had no history of trauma and infectious disease had been ruled out. After several nonspecific orthopedic procedures and inadequate treatment of signs and symptoms, he was finally diagnosed with local TGCT.
 Conclusion: To make the correct diagnosis, the unusual and somehow deceptive clinical presentation of TGCT must be considered.

PREVALENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) AMONG CORONARY ARTERY DISEASE PATIENTS AND ITS ASSOCIATION WITH CAD SEVERITY

Background: Non-alcoholic fatty liver disease (NAFLD) is a growing concern due to its potential to lead to liver transplants and its association with cardiovascular disease (CVD). However, the relationship between NAFLD and CVD remains debated, and non-invasive diagnostic methods for NAFLD are recommended. This study aimed to estimate the prevalence of NAFLD among patients with CAD and explore the association between CAD severity and the probability of developing NAFLD.
 Methodology: A cross-sectional study was conducted among CAD patients. Patients with a history of infectious liver disease, pregnant or lactating individuals, and those with excessive alcohol consumption were excluded. Coronary angiography was performed to assess CAD severity using the Gensini score. Ultrasonography and non-invasive assessments, such as the Fibrosis-4 (FIB-4) index, were used to diagnose and stage NAFLD.
 Result: The study included 156 CAD patients, with 79 (50.6%) being male. Out of total, 31 (19.8%) had severe, 79(50.6%) had moderate, and 46 (29.48%) had mild NAFLD. Male patients showed a significantly higher prevalence of severe NAFLD compared to females. There was no significant difference in the mean age of CAD patients across NAFLD severities. Severe NAFLD was associated with higher mean Gensini scores and FIB-4 values compared to mild to moderate NAFLD patients. A positive correlation was found between Gensini score and FIB4, suggesting that Gensini score could be an alternative to FIB4 in diagnosing NAFLD severity among CAD patients.
 Conclusion: The study revealed a high prevalence of NAFLD among CAD patients, with severe NAFLD being associated with higher CAD severity.

Influence of Parents' Height and History of Infectious Diseases on Stunting Incidence Children in Wundulako District Kolaka Regency

Backgrounds: Preliminary surveys that have been conducted in Kolaka Regency show that stunting is caused by various factors, including factors of inadequate nutritional intake for toddlers, inadequate nutritional intake during pregnancy, factors of giving the wrong diet to children, social factors, economics, knowledge and other factors. as well as existing data show that the prevalence of stunting in Kolaka Regency is relatively high. This is the reason for conducting research on the Effect of Parents Height and History of Infection on Stunting Incidents in Children in Wundulako District, Kolaka Regency
 Methods: Quantitative research uses a cross sectional study design. The population in this study were all children under five aged 0-59 months who were stunted in the working area of ​​the Wundulako Health Center with a total of 218 children under five, the sample was drawn using non-probability sampling with a sample size of 67 under five.
 Results: Value Statistical Test (X2hit)= 8.242 > X2tab= 3.841, meaning that there is an influence of parents' height and(X2hit)= 36,548 > X2tab =3.841, meaning that there is an effect of a history of infection on the incidence of stunting in Wundulako District, Kolaka Regency.
 Conclusion: Active efforts are needed to increase information about stunting, and how to prevent it as early as possible, especially for pregnant women who are at risk of giving birth to children with stunting.

Analysis of Host and Socio-Economic Factors as Risk Factors for Stunting in Toddlers in the Working Area of the Kesesi II Health Center, Pekalongan Regency, Indonesia

Stunting or failure to thrive causes difficulties for toddlers in achieving optimal physical and cognitive development. Kesesi District is in first place and the Kesesi II Health Center as of February 2023 still has a high stunting rate, namely 165 cases. This study aimed to analyze host factors as risk factors for stunting in toddlers in the working area of the Kesesi II Health Center. This research is an analytical research with a quantitative approach and a case control research design. From the Chi-square test, the results of the maternal pregnancy history were obtained (p-value = 0.000, OR = 6.089, 95% CI = 2.146 - 17.276) history of infectious diseases in toddlers (p-value = 0.000, OR = 8.516, CI 2.953 - 24.561), history of exclusive breastfeeding (p-value = 0.021, OR = 3.478, 95% CI = 1.172 - 10.323), history of LBW (p-value = 0.000, OR = 10.500, 95% CI 3.628 - 30.392), family economic status ( p-value = 0.287, OR = 2.188, 95% CI = 0.505 - 9.480). This study shows that the mother's history of pregnancy, history of infectious diseases, history of exclusive breastfeeding, and history of LBW are host factors that are at risk for the incidence of stunting in toddlers in the Kesesi II Health Center working area in 2023.

Edukasi Cuci Tangan Pakai Sabun (Ctps) Sebagai Upaya Pencegahan Tranmisi Penyakit Dalam Keluarga Di Desa Mesjid Bungie

Washing your hands with soap and running water can clean your hands of dirt and germs. Dirt and germs can cause various diseases, such as diarrhea, upper respiratory tract infections, avian influenza, hepatitis A, worms, skin and eye diseases. The aim of this activity is to increase family knowledge about the importance of washing hands with soap as an effort to prevent disease transmission so that there is a change in attitudes towards clean and healthy living behavior. The target of this service is families who have family members with a history of infectious diseases in the last 3 months. This service provides health education about handwashing with soap as an effort to prevent disease transmission in the family. It is hoped that the implementation of this education can improve healthy living behavior in families and understand the prevention of disease in family members as an effective preventive measure to reduce the risk of disease transmission

Risk factors for 6-to-24-month-old toddlers in district of Tanara: survey of hygiene sectors, worm infection, and complementary feeding to reduce stunting

Background: Children in Indonesia still struggle against being stunted, wasted, and underweight. In 2018, 30.8 % of children under five years old were stunted, in 2022, it had decreased to 21.6%. The stunting rate in Pandeglang Regency in 2019 was 41.6%, whereas the incidence in Banten Province was 24.1%. This study aims to determine factors that influence the occurrence of stunting in children aged 6–24 months in Tanara District, Serang Regency, Indonesia. Methods: A cross-sectional approach was used on a sample consisting of 40 mothers with children aged 6–24 months in September 2020, selected using consecutive sampling from nine subdistricts. Results: Of the total respondents, 21 (52.5%) have stunted children aged 6–24 months, 28 (70%) children had completed exclusive breastfeeding, and 65% had poor knowledge of complementary feeding. Findings reveal a relationship between the incidence of stunting and the history of infectious disease, a lack of complementary feeding knowledge, and a lack of a healthy life attitude. Conclusions: The most influential factor in stunting in children aged 6–24 months was the history of infectious disease and the attitude toward a healthy life. A lower history of infectious disease in children under five will give a low incidence of stunting; conversely, a higher attitude toward healthy living lowers the incidence of stunting. In this study, the specific nutrition intervention programs required are learning classes for mothers, whether they are mothers of infants/toddlers or pregnant women. Moreover, the improvement of sensitive intervention programs for environmental hygiene needs to be encouraged, which is conducted by the local government and the community. The need to integrate nutrition-specific and sensitive interventions into efforts to improve children’s health should be met so that the handling of nutritional problems can be sustainable.

Risk Factors Associated with Nutritional Status of Toddlers

The main nutritional problem is when growing children experience severe malnutrition. Such as the mother's education level, occupation, number of family members, family income, knowledge, history of exclusive breastfeeding, and history of infectious diseases are several variables that influence a child's nutritional status. Body weight for age (WW/U) based on Z-score -3 SD to <-2 SD is the threshold for undernutrition. The aim of this research was to determine the factors related to the nutritional status of toddlers in the UPTD work area of the Kubangdeleg Community Health Center, Cirebon Regency, West Java Province. This research uses a cross sectional study design and is an observational analytical study. The sample size of 100 people is mothers who have toddlers aged 12-59 months. Data collection was carried out through interviews and anthropometric measurements as well as community health center reports. Then the data was analyzed univariate and bivariate with the Chi-square test. Maternal education obtained (p-value=0,027), number of family members (p-value=0,317), maternal knowledge about nutrition (p-value=0,756), history of exclusive breastfeeding (p-value=1,000), and history of infectious diseases (p-value=0,693). There is a relationship between the level of maternal education and the nutritional status of toddlers. Meanwhile, in the UPTD work area of the Kubangdeleg Community Health Center, Cirebon Regency, West Java Province. Several factors including the number of family members, mother's knowledge, history of exclusive breastfeeding and history of infectious diseases are not risk factors for nutritional status in toddlers.

A Comparative Analysis of Epidemics Management in Korea: From the Unification of Shilla to Modern COVID-19

Epidemics have been a major threat to human health throughout history. The development of modern medicine has led to a decline in deaths from infectious diseases, but they remain a major public health concern. The COVID-19 pandemic has highlighted the importance of effective infectious disease management. This study examines the management of infectious diseases in Korea. The study finds many similarities between how infectious diseases were managed in the past and how they are managed today. However, the study also finds some critical differences between how contagious diseases were managed in the past and how they are managed today. The study concludes by arguing that studying the history of infectious diseases can help us better understand and manage infectious diseases in the future.