Indonesia Basic Health Research Research Articles

Passive Smoking is Strongly Associated with Heart Disease in Hypertensive Workers: Analysis of the 2018 Indonesia Basic Health Research

Abstract Introduction: This study examined the association between smoking and heart disease in workers with a medical history of hypertension. Methods: Data were obtained from the 2018 Indonesian Basic Health Research database. Information was collected from 80,602 respondents who met the inclusion criteria: workers between the ages of 15 and 64 years who were exposed to cigarettes and had a medical history of hypertension. Multivariate logistic regression analysis assessed the association between smoking behavior and heart disease in workers with hypertension. Results: A strong association was observed between passive smoking and heart disease. The odds of developing heart disease were significantly higher in passive smokers who were former cigarette smokers than passive smokers who never smoked a cigarette (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [CI]: 1.85–2.41). However, the odds were lower in current smokers than in passive smokers without a history of cigarette smoking (aOR = 0.71, 95% CI: 0.63–0.79). In addition, the present study found that the odds of developing heart disease increased in respondents from urban areas (aOR = 1.27, 95% CI: 1.14–1.40), aged 46–64 years (aOR = 2.12, 95% CI: 1.90–2.36), and from high-level economic status (aOR = 1.41, 95% CI: 1.27–1.58). Conclusion: Implementing health advocacy initiatives, expanding smoking-free zones, and enhancing workplace anti-smoking policies are important for preventing and reducing the harmful effects of cigarette smoking among workers, particularly those with conditions that make them more susceptible, such as hypertension.

Correlation between Family Support and Health Professional Education on Tuberculosis Patient Compliance at Public Health Centers Tasikmalaya

Tuberculosis prevalence in Indonesia is still high, as 824,000 people are infected with Tuberculosis (Indonesia Basic Health Research 2022). This shows that Tuberculosis is still difficult to control due to various factors, including patient compliance. Patient compliance can be influenced by family support and health professional’s education about Tuberculosis therapy, which plays an important role in increasing knowledge of correct therapy for patients and families. This study examines the influence of family support and health professional education on tuberculosis patient compliance. This is a descriptive study with the cross-sectional method. Data was collected from 52 Tuberculosis patients who met the inclusion criteria using a questionnaire. The result shows that family support and health professional education had very good scores (84.6% and 46.2%) on Tuberculosis patients. This affects patient compliance is very good (82.7%). Based on correlation results, it shows that there is a direct influence of family support (p-value<0.05). At the same time, there is an indirect influence of health professional education on patient compliance (p-value>0.05). This shows that family support has a greater direct influence than health professional education on tuberculosis patients’ compliance. However, health professionals still play an important role because the patient's family also receives education from health professionals.

A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys

BackgroundAlthough child malnutrition has been reducing, the coexistence in mothers and children of various forms of malnutrition has continued to rise around the world. In the Indonesian context, a knowledge gap exists on the coexistence of multiple malnutrition burdens. This study examines trends in the coexistence of the triple burden of malnutrition (TBM) among mother–child pairs living in the same house and explores multilevel (individual, household, and community) factors associated with TBM in Indonesia.MethodsWe used data from the 2013 and 2018 Indonesia Basic Health Research, the nationally representative survey of the Indonesian population, as repeated cross-sectional surveys. Study samples were mothers and children (0–59 months old), who resided in the same household and indicated by the same identifier number. The anthropometric measurements of the mothers and children, and the hemoglobin levels of the children were collected. We employed a multilevel mixed-effects model to consider the hierarchical data structure. The model captured the role of cluster, district, provincial differences, and the individual, household, community-level, and TBM status characteristics.ResultsOf 3,891 mother–child pairs analyzed, 24.9% experienced TBM. Girls had 63% higher odds than boys of TBM (aOR: 1.63; 95% CI: 1.30 to 2.03). Significantly lower odds were found in children of mothers who had a gestational age lower than 37 weeks (aOR: 0.72; 95% CI: 0.55 to 0.94). At the household level, children with a father who had a high-school, primary-school, or no school education had significantly higher odds of TBM than children of fathers who had graduated from academy. Children of mothers who visited Antenatal Care (ANC) no more than 6 times had significantly lower odds (aOR: 0.65; 95% CI: 0.47 to 0.88). Children of mothers who consumed Iron and Folic Acid (IFA) supplements had significantly lower odds.ConclusionTBM is related to characteristics at not just the individual level but also the family and community levels. To achieve significant outcomes, integrated nutrition interventions in Indonesia should also consider family and community factors.

Predictors of chronic kidney disease among Indonesian adult population: Results from the 2018 Indonesia Basic Health Research

Background:Three out of ten cases of chronic kidney disease (CKD) are cause by type 2 diabetes mellitus (T2DM). In addition, nutritional status, consumption of unhealthy foods, high blood pressure, and smoking habits were also previously identified as risk factors to CKD but there is a scarcity of data from Indonesia. Therefore, we sought to determine the risk factors using a predictive model for the incidence of CKD in Indonesia based on the Indonesia Basic Health Research 2018.Methods:Secondary data from the 2018 Indonesia Basic Health Survey with 300,000 respondents was used. Respondents with complete socio-demographic, food consumption data, anthropometric data and chronic disease status (i.e. T2DM and hypertension) type 2 were analyzed (n=96,098). Binary logistic regression model was performed to assess the association between socio-demographic, food group consumption, health and nutritional status with CKD.Results: Based on the final model of logistic regression analysis, ranging from the most and least factors that contribute to CKD were the presence of T2DM (p<0.000; OR=2.353), hypertension (p<0.000; OR=1.695); education level (p=0.028; OR=1.438), living area (p=0.025; OR=1.242); age (p<0.000; OR=0.979); and sugary drink consumption (p=0.050; OR=0.884).Conclusions:Prediction equation of CKD risk factor in Indonesia Adult included 6 factors that are present: diabetes, present hypertension, education, living area, age, and sugary drink consumption. This result can be used by the health professional to predict the risk of CKD among patients with present diabetes and/or hypertension.

Blood pressure to height ratio for screening hypertension among Indonesian adolescents

Background Pediatric hypertension is an emerging health issue due to its increasing prevalence. Age-, gender-, and height-specific blood pressure percentiles have been widely used as a primary tool for detection of hypertension in the pediatric population. However, this method is too complicated to be used in general pediatric practice. The blood pressure to height ratio has been proposed as a practical tool to detect hypertension in children.
 Objective To evaluate the accuracy of blood pressure to height ratio to be used as a tool for screening high blood pressure in Indonesian adolescents.
 Methods This diagnostic test study using data from the 2013 Indonesia Basic Health Research (Riset Kesehatan Dasar/RISKESDAS) report included 39,057 adolescents aged 15-18 years with complete data on age, gender, weight, height, and blood pressure. Blood pressure values were classified using the 2017 American Academy of Pediatrics (AAP) hypertension clinical guidelines. Blood pressure to height ratio was calculated as mmHg/cm body height. A receiver-operator characteristics (ROC) curve analysis was performed to assess the accuracy of systolic blood pressure to height ratio (SBPHR) and diastolic blood pressure to height ratio (DBPHR) for screening high blood pressure in adolescents. The optimal cut-off points, sensitivity, and specificity of SBPHR and DBPHR were calculated.
 Results The optimal cut-off points for defining elevated blood pressure in male adolescents aged 13-18 years were SBPHR 0.69 for male adolescents (sensitivity 96%, specificity 80%) and DBPHR 0.46 (sensitivity 97%, specificity 84%). In female adolescents, the optimal cut-offs were SBPHR 0.72 (sensitivity 97%, specificity 82%) and DBPHR 0.48 (sensitivity 98% and specificity 79%).
 Conclusion Blood pressure to height ratio is a practical method with high sensitivity and specificity for detecting elevated blood pressure in Indonesian adolescents aged 15 to 18 years.

Obesity and Asthma Risk in Indonesian Adults: Findings from the 2018 Indonesia Basic Health Research

Obesity and asthma are both global public health challenges. Mounting evidence suggests that obesity may increase asthma risk in adults; however, the association by sex remains uncertain. This study examined the association of obesity with asthma risk in Indonesian adult men and women. Data were obtained from the 2018 Indonesia Basic Health Research. The analysis included 299,837 men and 333,218 women aged ≥18 years. Asthma was identified by the self-report of a doctor’s diagnosis. Obesity was defined as a body mass index ≥30 kg/m2. A logistic regression was used for data analysis. Asthma prevalence was 2.7% (2.5% in men and 2.8% in women) and was higher in obese than non-obese adults. The adjusted odds ratio (aOR) of having asthma-related obesity was 1.22, 95% Confidence Interval (CI) = 1.17–1.28 (aOR = 1.25, 95% CI = 1.21–1.34 in women and aOR = 1.14, 95% CI = 1.05–1.25 in men). In conclusion, asthma prevalence was relatively low in Indonesian adults and slightly higher in women than men. Both men and women had a slight increase in the odds of having asthma-related obesity. Longitudinal studies are needed to understand better the causality association of obesity with asthma in adults.

Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia.

In East Nusa Tenggara Province, Indonesia, 42.6% of children under five had stunted growth in 2018, which affects both individual and communal levels. The first step in creating effective interventions is identifying the risk factors for stunting. This study aims to pinpoint the stunting risk factors in East Nusa Tenggara Province, Indonesia, by incorporating secondary data from the 2018 Indonesia Basic Health Research (RISKESDAS). This study implemented a cross-sectional design by utilizing the data of individuals who were successfully visited during the survey. Initial data screening in East Nusa Tenggara Province based on the criteria for children aged 0−59 months and stunting showed as many as 1643. Multivariate logistic regression analysis was performed to evaluate the relationship between children’s characteristics and stunting. There was a significant relationship between age group variables for younger children (aged 12−23, 24−35, and 36−47 months), mothers with low education, and children living in rural areas with the incidence of stunting in children (p-value < 0.05). The dominant factors that caused stunting in this study were the children’s age of 24−35 months (OR = 2.08, 95% CI: 1.12−3.86), mothers with low education (OR = 1.57, 95% CI: 1.18−2.08), and children living in rural areas (OR = 1.39, 95% CI: 1.01−1.91). The highest prevalence of stunting was in the group of children aged 12−23 months (45.2%). To prevent child stunting, the government must intervene for mothers with low education and those living in rural areas. Intervention includes intensive socialization about improving nutritional status during pregnancy and practicing complementary feeding and breastfeeding habits until the child is 24 months old.

RISK FACTORS FOR HYPERTENSION INCIDENCE AMONG WOMEN IN INDONESIA

Indonesia is one of the countries with the highest cases of hypertension, namely 34.1% of the population in Southeast Asia, This study further elaborates the hypertension prevalence in Indonesian women older than 15 years with their modifiable risk factors. This study uses data from the Indonesia Basic Health Research (Riskesdas) 2018 with a cross-sectional study design and total sampling method. The data were analysis further by chi-square test and multiple logistic regression (a = 0,05) in relation to their modifiable risk factors. The risk factors covered were age, contraception use, level of education, smoking behaviour, alcohol consumption, unhealthy food consumption, underweight BMI, fat-based BMI and stress. The data processing resulted in that age provides (p = &lt;0.001; POR=1.883), contraception type (p = &lt;0.001; POR=1.007), education (p = &lt;0.001; POR=1.478), smoke (p = &lt; 0.001; POR=0.867), alcohol consumption behaviour (p = &lt;0.001; POR=0.879), risky food consumption behaviour (p = &lt;0.001; POR=1.120), BMI underweight category (p = &lt;0.001; POR=0.536), BMI category fat (p = &lt;0.001; POR = 2.245), and stress (p = &lt;0.001; POR = 0.942) had a significant relationship with the incidence of hypertension in Indonesian women older than 15 years. It was found that the fat-based BMI factor was the significant prevalence of hypertension occurring in Indonesian women older than 15 years.

Mapping of health care facilities, dental visits and oral health problems in Indonesia to prevent COVID-19 transmission

Background: One of the goals of Indonesia’s participation in sustainable development goals is to improve its health state. Efforts to achieve health improvement are increasing the availability of health care facilities so people can easily access and get treatment for dental and oral health. As we know, the first case of COVID-19 in Indonesia was found in March 2020 and all cases were spread over 34 provinces. During this pandemic situation, health care facilities and some dental treatments generating aerosols are one of the environments that can potentially transmit COVID-19 to the community. Dentists have the riskiest job because they must be less than two meters from patients. Purpose: This study aimed to evaluate the distribution of health care facilities, dental visits and oral health problems to prevent increased exposure to COVID-19 by using a geographic information system to explore the distribution of regional data. Methods: This study is a secondary data analysis and used data from Indonesia Basic Health Research 2018 and Health Facility Research 2019. Data of health care facilities, dental visits and oral health problems were tabulated using MS Excel version 16.45. Spatial mapping was done using Quantum Geographic Information System Desktop version 3.18.3 based on open-source software. Results: Java Island has the highest distribution of health care facilities and receives treatment from the dentist. COVID-19 reached a peak in June–July 2021, and Java Island became the region with the highest incidence rate. Conclusion: The distribution of health care facilities and dental visits was in line with the spread of the COVID-19 virus in 34 provinces. Almost all treatments of oral health problems need a highspeed rotary instrument, which can be a source of transmission of this virus.

The ABC Analysis of Drug Use and Cost in Cardiology Outpatients -National Health Insurance

Background: Cardiovascular disease is one of the chronic diseases with an increasing prevalence from year to year. The results of Indonesia's basic health research (RISKESDAS 2018) showed that it was experienced by 2.9% of the population. Ensuring the continuity of drug availability is very important in pharmacy services for this patient group. The history of drug use is considered in the planning dan procurement of drug products. Objective: This study aims to analyze the drug use pattern and cost of drugs for cardiology outpatients in the National Health Insurance scheme (JKN). Methods: A retrospective observational study was conducted using the prescription of cardiology outpatients JKN for March-May 2021. The ABC method carried out the analysis of drug use patterns and cost. Results: From 2,986 prescriptions for cardiovascular disease, there were 94 types of drugs from 37 therapeutic classes. In the ABC analysis of drug use for class A, 68.82% contained seven types of drugs, class B, 20.55% contained nine types of drugs, and class C, 10.63% with 78 types of drugs. The results of ABC analysis for investment value (cost) of drugs class A 66.96% contained two types of drugs, class B 19.81% with four types of drugs, and class C 14.23% with 88 types of drugs. Conclusion: ABC analysis of the drug use pattern and cost/investment showed different patterns which had value to consider in procurement planning to maintain service continuity.

Determinants of anemia in women of reproductive age in Indonesia: Secondary data analysis of the 2018 Indonesia Basic Health Research

Background and purpose: Anemia in women is a public health concern that is prevalent in developing countries. Women of reproductive age (WRA) frequently suffer from anemia, which can contribute to morbidity and mortality of mothers and their infants. The purpose of this study was to determine the prevalence and factors associated with anemia among women of reproductive age (WRA) in Indonesia. Methods: This study uses secondary data from the 2018 Indonesia Basic Health Research or Riset Kesehatan Dasar (Riskesdas) which was conducted in 34 provinces in Indonesia. The number of samples analyzed was 3,677 women aged 15-49 years who had data from interviews, measurements of height, weight, results of malaria\ tests, and hemoglobin levels. Data analysis was performed using multivariate logistic regression to determine the relationship between anemia and individual characteristics, nutritional and health status as well as environmental conditions and healthservice accessibility. Results: The prevalence of anemia among WRA in Indonesia was 25.3% (95%CI: 23.9-26.7). Factors which found to be associated with the prevalence of anemia in WRA were age &lt;20 years (AOR=3.44; 95%CI: 2.22-5.35; p&lt;0.001), underweight (AOR=1.48;95%CI: 1.08-2.05; p=0.017), obesity (AOR=0.68; 95%CI: 0.56-0.81; p&lt;0.001) and the use of hormonal contraception (AOR=0.53;95%CI: 0.44-0.64; p&lt;0.001). Conclusion: Based on the prevalence, anemia among WRA inIndonesia is categorized as a moderate public health concern and the most common risk factor for anemia was WRA aged &lt;20 years and underweight. To reduce the incidence of anemia in WRA, interventions should be targeted at WRA aged &lt;20 years and underweight

Detection of Mental Emotional Disorder Symptoms using SRQ-20 in Pregnant Women: A Case Example from South Sulawesi, Indonesia

The maternal health condition in Indonesia still requires special attention in terms of prevention and management of mental-emotional disorders. Meanwhile, the Indonesia Basic Health Research in 2013 results show that the prevalence of mental-emotional disorder was approximately 6% in each of the different provinces. This study aims to detect the prevalence of mental-emotional disorders symptoms in pregnant women and examine the relations with age, education, occupation, number of children ownership, MUAC (Mid-Upper Arm Circumference), and blood pressure. This is an analytical observational study conducted using a cross-sectional design on pregnant women that participated in antenatal examination visits to health facilities. The location was 60 Private Delivery Centers, 244 Public Health Centers, and 259 Hospitals. The sampling site was carried out in three different places, which focused on three areas of South Sulawesi in Makassar, Maros, and Pangkep. The pregnant woman within the age range of 20-35 years shows 71,3% with a p-value=0,080 having mental-emotional disorder symptoms and 71,5% of mothers with less than two children predominantly experienced mental-emotional disorders symptoms with a p-value=0,078. Hence, it is important to address this issue because the mental and emotional problems in pregnant women can potentially lead to adverse effects, both for the women and the baby.

Quality of Handwashing in Informal Workers in Indonesia

Introduction: Worker behavior of handwashing with soap in the informal sector has rarely not been studied in Indonesia. This study was conducted to determine factors related to the quality of handwashing performed by workers in the formal and informal sectors in Indonesia. Methods: The research used secondary data from Indonesia Basic Health Research. The research design was cross-sectional, and a total sample included was 421,404 workers at the productive age of 15-64 years across 34 provinces in Indonesia. The data collected included age, gender, marital status, education, place of residence, occupation, and handwashing practice. The determinants were identified using binary logistic regression. Results and Discussion: Results showed that 1.9% of workers did not wash their hands, and 35.0% only washed their hands with water; most of them worked in the informal sector (77.5%). Regarding the characteristics of workers, age (OR=1.17; 95% CI: 1.14–1.21), gender (OR=1.23; 95% CI: 0.93–0.99), education (OR=2.07; 95% CI: 2.01–2.14), and formal workplace (OR=1.43; 95% CI: 1.40-1.46) were mostly related to the quality of handwashing. Conclusion: The government is expected to formulate a structured policy in educating the workers, especially for male, young (15-24 years), low educated, and informal workers, about good handwashing. This study recommends that the government should use the current research findings to target proper population for the policy implementation.

The Association of Oxygen Saturation and Haemoglobin Level on Elderly

According to the World Health Organization (WHO), the elderly is a population group aged 60 years or more. In 2010 the number of elderly people was recorded at 18.1 million people or 17.6%. In 2014 the number increased to 18.8 million people. The number in Indonesia is estimated to reach 28.8 million people or 11.34 percent of the total population in 2020. Data from Indonesia Basic Health Research 2018 showed that most of the elderly in Indonesia have degenerative diseases such as diabetes and heart disease [1]. In the 21st century, a special challenge in the health sector is the increasing number of elderly with degenerative problems and non-communicable diseases (NCDs) such as diabetes, hypertension, and mental health disorders (depression, dementia, anxiety disorders, and sleeping disorder). These diseases will cause serious problems if they are not addressed or if prevention is not carried out. This condition causes the elderly to be vulnerable to serious complications. Hemoglobin (Hb) is an iron-rich protein in red blood cells whose function is to carry oxygen throughout the body. This protein also functions to give blood its red color. In order to function properly, the hemoglobin level in the blood must be within the normal range. Oxygen saturation is the fraction of hemoglobin oxygen saturation relative to the total hemoglobin in the blood. The human body requires and regulates a very precise and specific balance of oxygen in the blood. The normal arterial blood oxygen saturation level in humans is 95-100%. Objective: The objective is to determine the relationship between oxygen saturation and Hemoglobin levels in the Elderly. Method: This study is an analytic observational study with a cross-sectional design. The research subjects are elderly people aged ≥ 60 years who live in Malalayang Dua Village, Manado City. In this study, the reference value of normal oxygen saturation is 95-100% and the Reference Value of Hb based on WHO, men &lt; 13 g/dL, .............

Diversity of Oral Microbiome of Women From Urban and Rural Areas of Indonesia: A Pilot Study.

Objective: The studies on the influence of geographical and socio-economic factors on the oral microbiome remain underrepresented. The Indonesia basic health research (RISKESDAS) 2018, showed an increasing trend in non-communicable diseases compared with the previous report in 2013. The prevalence of diabetes, heart disease, hypertension, and obesity are reported to be higher in urban areas than in rural areas. Interestingly, non-communicable diseases were found to be more prevalent in women than men. This pilot study aimed to examine the oral health and oral microbiome derived from tongue samples of healthy Indonesian women from urban and rural areas.Methods: Twenty women aged 21–47 years old from West Jakarta, residents of DKI Jakarta (n = 10) as representative of the urban area, and residents of Ende, Nangapanda, East Nusa Tenggara (n = 10) as representative of the rural area were recruited for this pilot study. The participants were evaluated by the Simplified Oral Hygiene Index (OHI-S) according to the criteria of Greene and Vermillion and divided into three groups. High-throughput DNA sequencing was performed on an Illumina iSeq 100 platform.Results: The principal component analysis displayed a marked difference in the bacterial community profiles between the urban and rural localities. The presence of manifest was associated with increased diversity and an altered oral bacterial community profile in the urban women. Two bacterial taxa were present at significantly higher levels (adjusted p < 0.01) in the urban oral microflora (Genus Prevotella and Leptotricia) could account for this difference irrespective of the individual oral hygiene status. The linear discriminant analysis effect size (LEfSe) analysis revealed several distinct urban biomarkers. At the species level, Leptotrichia wadei, Prevotella melaninogenica, Prevotella jejuni, and P. histicola, show an excellent discriminatory potential for distinguishing the oral microflora in women between urban and rural areas. Further, using SparCC co-occurrence network analysis, the co-occurrence pattern in the dominant core oral microbiome assembly was observed to be specific to its ecological niche between two populations.Conclusions: This is the first pilot study demonstrating the characterization of the oral microbiome in Indonesian women in urban and rural areas. We found that the oral microbiome in women displays distinct patterns consistent with geographic locality. The specific characterization of the microbiota of Indonesian women is likely linked to geographical specific dietary habits, cultural habits, and socio-economic status or the population studied.

Analisis Determinan Faktor yang Berhubungan dengan Kejadian Kurang Energi Kronik (KEK) pada Ibu Hamil di Wilayah Gunung Sindur, Bogor

Chronic Energi Deficiency (CED) is a nutritional problem in pregnant women with a prevalence of 17,3% based on Indonesia Basic Health Research or Riset Kesehatan Dasar (Riskesdas) in 2018. Based on age groups, pregnant women who experienced the highest CED were 15-19 years (38,5%). So it is very important to know what factors are related to CED in pregnant women. The purpose of this study was to analyze determinants factors with the incidence of chronic energy deficiency in pregnant women at Gunung Sindur Bogor. This study was an observational study with a cross-sectional approach. Respondents in this study were 70 pregnant women who were selected by purposive sampling. Bivariate analysis was performed using the Chi-Square test and logistic regression for Multivariat analysis. The bivariate analysis showed that there were a relationship between age (p = 0.009), parity (p = 0.027) nutritional knowledge (p = 0.045), energy intake (p = 0.001), and protein intake (p = 0.007) with the incidence of CED in pregnant women. The multivariat results show that energy intake is the most dominant factor associated with the incidence of CED (p = 0.001) in pregnant women at Mount Sindur Bogor.

The Relationship between Type 2 Diabetes Mellitus with Chronic Kidney Disease In Indonesian Population In 2014-2015 (Data Analysis of IFLS 5)

In 2010, the Global Burden of Disease research revealed that cases of chronic kidney disease had increased and became a serious health problem. Indonesia Basic Health Research data in 2013 revealed that the proportion of patients with chronic kidney failure aged ≥ 15 years old based on doctor's diagnosis was 0,2% and 0,6% kidney stones. Therefore the aim of the study is to analyze the relationship between type 2 diabetes mellitus and chronic kidney disease in the population of Indonesia in 2014-2015. This type of research is observational with a cross-sectional design. The study used secondary data from the Indonesia Family Life Survey (IFLS) 5 in 2014-2015. The sampling technique used total sampling, which found 34,012 people who met the inclusion and exclusion criteria. The independent variables of this study are type 2 diabetes mellitus and chronic kidney disease as the dependent variable. Covariate variables are age, sex, smoking status, history of hypertension, and history of high cholesterol. Analysis bivariate of the relationship between type 2 diabetes mellitus and chronic kidney disease in this study using chi square and multivariate analysis using logistic regression test. The magnitude of the effect expressed in the prevalence odds ratio (POR) with confident interval (CI: 95%.) This study shows the prevalence of chronic kidney disease in Indonesia population in 2014 – 2015 is 1%. The result of chi-square test of the relationship between type 2 diabetes mellitus and chronic kidney disease in the Indonesian population showed POR=2.48 (p-value =0.0002; 95%CI 1.422-4.071). Multivariate analysis with logistic regression tests shows that smoking status, history of high cholesterol, and history of hypertension influence the relationship of type 2 diabetes mellitus and chronic kidney disease.

Diabetes, Hypertension, Obesity, and Smoking as Risk Factors for Chronic Kidney Disease in Productive Age

Background: Based on the Indonesia basic health research report in 2018, the prevalence of chronic kidney disease (CKD) in the productive age group in Indonesia had increased from the previous year, to 1.97%. This condition can cause various complications that contribute to the high morbidity, which affects quality of life and productivity, so risk factors for CKD need to be understood to prevent the occurrence of the disease. Purpose: This study aimed to analyze the risk factors associated with CKD in the Indonesian productive-age population. Method: This study used data sourced from Indonesian Family Life Survey 5 (IFLS-5) with a cross-sectional research design. The study population was composed of all Indonesian residents who were respondents of IFLS-5. The research sample was made up of respondents aged 15–64 for whom complete information was available. The sample size was 29,120 respondents. The variables analyzed in this study were diabetes, hypertension, obesity, smoking, and CKD. The analysis method used was the chi-square test. Results: Bivariate analysis showed a significant relationship between CKD and diabetes (p = 0.01; prevalence ratio [PR] = 2.71; 95% CI = 1.74–4.22), hypertension (p = 0.01; PR = 2.62; 95% CI = 2.08–3.30), obesity (p = 0.01; PR = 1.67; 95% CI = 1.25–2.23), and smoking (p = 0.01; PR = 1.43; 95% CI = 1.17–1.75) in the productive age group in Indonesia. Conclusion: Diabetes, hypertension, obesity, and smoking have a significant relationship with CKD in the productive age group in Indonesia.

Effect of probiotic Lactobacillus plantarum Dad-13 powder consumption on the gut microbiota and intestinal health of overweight adults.

BACKGROUNDShifting on lifestyle, diet, and physical activity contributed on increasing number of obese people around the world. Multiple factors influence the development of obesity. Some research suggested that gut microbiota (GM) plays an important role in nutrient absorption and energy regulation of individuals, thus affecting their nutritional status. Report of Indonesia Basic Health Research showed that the prevalence of obesity in every province tended to increase. Although the root cause of obesity is excessive calorie intake compared with expenditure, the differences in gut microbial ecology between healthy and obese humans may affect energy homeostasis. GM affect body weight, especially obesity. Probiotics that are consumed while alive and able to colonize in the intestine are expected to increase the population of good bacteria, especially Bifidobacteria and Lactobacilli, and suppress pathogens such as Enterobacteriaceae and Staphylococcus. The strain of L. plantarum Dad-13 has been demonstrated to survive and colonize in the gastrointestinal tract of healthy Indonesian adults who consume fermented milk containing L. plantarum Dad-13. The consumption of probiotic L. plantarum Dad-13 powder decreased E. coli and non-E. coli coliform bacteria in school-aged children in Indonesia. L. plantarum is a dominant bacterium in the average Indonesian’s GM. For this reason, this bacterium is probably a more suitable probiotic for Indonesians.AIMTo determine the effect of the consumption of indigenous probiotic Lactobacillus plantarum Dad-13 powder in overweight adults in Yogyakarta (Indonesia).METHODSSixty overweight volunteers with a body mass index (BMI) equal to or greater than 25 consume indigenous probiotic powder L. plantarum Dad-13 (2 × 109 CFU/gram/sachet) for 90 d. The study was a randomized, double-blind, placebo-controlled study. The volunteers filled in a diary on a daily basis, which consisted of questions on study product intake (only during ingestion period), other food intake, number of bowel movements, fecal quality (consistency and color), any medications received, and any symptom of discomfort, such as diarrhea, constipation, vomiting, gassing, sensation of illness, etc. Fecal samples and the subjects’ diaries were collected on the morning of day 10 + 1, which was marked as the end of the baseline period and the start of the ingestion period. During the ingestion period (from day 11 to day 101), several parameters to measure and analyze the results included body weight and height (once a month), the lipid profile, GM analysis using MiSeq, short-chain fatty acid (SCFA) analysis using gas chromatography, and the measurement of fecal pH using a pH meter.RESULTSThe consumption of indigenous probiotic powder L. plantarum Dad-13 caused the average body weight and BMI of the probiotic group to decrease from 84.54 ± 17.64 kg to 83.14 ± 14.71 kg and 33.10 ± 6.15 kg/m2 to 32.57 ± 5.01 kg/m2, respectively. No significant reduction of body weight and BMI in the placebo group was observed. An analysis of the microbiota showed that the number of Bacteroidetes, specifically Prevotella, increased significantly, while that of Firmicutes significantly decreased. No significant change in lipid profile in both groups was found. Also, no significant change in SCFAs (e.g., butyrate, propionate, acetic acid) and pH level was found after the consumption of the probiotic.CONCLUSIONNo significant differences in pH before and after ingestion were observed in both the probiotic and placebo groups as well as in the lipid profile of both cholesterol and triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and the LDL/HDL ratio. In addition, no significant changes in the concentration of SCFAs (e.g., acetic acid, propionate, and butyrate) were found after con-sumption. Interestingly, a significant decrease in body weight and BMI (P < 0.05) was determined in the treatment group. An analysis of GM shows that L. plantarum Dad-13 caused the Firmicutes population to decrease and the Bacteroidetes population (especially Prevotella) to increase.

Determinants of anemia in women of reproductive age in Indonesia: Secondary data analysis of the 2018 Indonesia Basic Health Research

Background and purpose: Anemia in women is a public health concern that is prevalent in developing countries. Women of reproductive age (WRA) frequently suffer from anemia, which can contribute to morbidity and mortality of mothers and their infants. The purpose of this study was to determine the prevalence and factors associated with anemia among women of reproductive age (WRA) in Indonesia.Methods: This study uses secondary data from the 2018 Indonesia Basic Health Research or Riset Kesehatan Dasar (Riskesdas) which was conducted in 34 provinces in Indonesia. The number of samples analyzed was 3,677 women aged 15-49 years who had data from interviews, measurements of height, weight, results of malaria tests, and hemoglobin levels. Data analysis was performed using multivariate logistic regression to determine the relationship between anemia and individual characteristics, nutritional and health status as well as environmental conditions and health service accessibility.Results: The prevalence of anemia among WRA in Indonesia was 25.3% (95%CI: 23.9-26.7). Factors which found to be associated with the prevalence of anemia in WRA were age &lt;20 years (AOR=3.44; 95%CI: 2.22-5.35; p&lt;0.001), underweight (AOR=1.48; 95%CI: 1.08-2.05; p=0.017), obesity (AOR=0.68; 95%CI: 0.56-0.81; p&lt;0.001) and the use of hormonal contraception (AOR=0.53; 95%CI: 0.44-0.64; p&lt;0.001). Conclusion: Based on the prevalence, anemia among WRA in Indonesia is categorized as a moderate public health concern and the most common risk factor for anemia was WRA aged &lt;20 years and underweight. To reduce the incidence of anemia in WRA, interventions should be targeted at WRA aged &lt;20 years and underweight.