Search Results (50)

Background and Objectives: Anemia and stunting are major public health concerns for young Indonesian children. Limited information is available from studies on multi-micronutrient supplements in Indonesia. The objective of this study was to investigate the effect of 12-month multi-micronutrient powder (MNP) supplementation on serum hemoglobin levels, anemia, and growth. Methods: A randomized double-blinded placebo-controlled study was performed, including 232 eligible children aged 8–10 months old. Children with severe anemia or stunting/those classed as underweight were not included as subjects. The study was performed in a low-socioeconomic-status community in Jakarta. With an active-to-placebo ratio of 60:40, 139 subjects received MNP sachets twice/day, and 93 subjects received placebo sachets, mixed with complementary food. The outcome parameters were hemoglobin level, anemia, and growth indicators. Per-protocol analysis was performed for 179 (intervention: 110; control: 69) subjects. Results: There were no differences at baseline between the groups, except for the weight-for-length z-scores (WLZ). Upon intervention, the serum hemoglobin level and anemia proportion did not change significantly within the group, and no significant differences were found between the groups (p > 0.05). However, subgroup analysis of non-anemic children at baseline showed a significant increase in hemoglobin levels in the youngest age group (8.0–8.9 months old) receiving MNP compared to placebo (0.13 vs. −0.79, p = 0.031). Iron deficiency anemia proportion showed a similar upward trend upon intervention in both groups. No significant differences in growth were found between both groups. Conclusions: This study failed to find a significant effect of 12-month MNP supplementation on serum hemoglobin level, anemia, and growth. Full article

The Wechsler Intelligence Scale for Children (WISC) is a widely used instrument for assessing cognitive abilities in children. While the latest fifth edition (WISC-V) has been adapted in various countries, Indonesia still relies on the outdated first edition, a practice that raises substantial concerns about the validity of diagnoses, outdated norms, and cultural bias. This study aimed to (1) adapt the WISC-V to the Indonesian linguistic and cultural context (WISC-V-ID), (2) evaluate its psychometric properties in a pilot study with an Indonesian sample, (3) reorder the item sequence of the subtests according to the empirical item difficulty observed in Indonesian children’s responses, and (4) evaluate the factor structure of the WISC-V-ID using confirmatory factor analysis. The adaptation study involved a systematic translation procedure, followed by psychometric evaluation with respect to gender, age groups, and ethnicity, using a sample of 221 Indonesian children aged 6 to 16 years. The WISC-V-ID demonstrated good internal consistency. Analysis of item difficulty revealed discrepancies in item ordering compared to the original WISC-V, suggesting a need for item reordering in future studies. In addition, the second-order five-factor model, based on confirmatory factor analysis, indicated that the data did not adequately fit the model, stressing the need for further investigation. Overall, the WISC-V-ID appears to be a reliable measure of intelligence for Indonesian children, though a comprehensive norming study is necessary for full validation. Full article

We have previously shown a difference between the gut microbiota composition of stunted and non-stunted children in East Nusa Tenggara, Indonesia. The current study aimed to perform an intervention with a probiotic, Lactiplantibacillus plantarum IS-10506, and its UHT-treated postbiotic compared to placebo in order to accomplish catch-up growth in the stunted children, possibly through modulation of the gut microbiota. Apart from the maltodextrin (placebo), probiotic, and postbiotic in chocolate milk, all groups also received a functional and nutritional biscuit and had access to newly constructed water wells as well as soap to improve hygiene. The results show that independent of treatment, the stunted children had a significantly higher increase in height and zlen (corrected for age) compared with their age- and gender-matched controls but a significantly lower increase in weight. Several potential pathogenic taxa declined in all groups, among which was Escherichia/Shigella (adjusted.p = 6.44 × 10⁻¹⁵), but so did some beneficial taxa, such as Bifidobacterium and Akkermansia. Faecalibacterium, which was already higher in the stunted children at baseline, increased independent of treatment. Changes in the relative abundance of several taxa of the microbiota correlated with the changes in anthropometric measures. In conclusion, although there was no difference between the interventions, understanding the dynamics and the role of the gut microbiota in this process might allow healthcare providers to develop targeted nutritional strategies aimed at optimizing health outcomes for children at risk of stunting, thereby addressing a critical global health issue. Full article

Stunting—defined by the World Health Organization as a height-for-age z-score < −2 SD—signals chronic undernutrition that impairs both physical and cognitive development. This study investigates how the three pillars of food security (availability, access, utilization) influence stunting prevention efforts in the Bondowoso Regency, East Java, Indonesia. A cross-sectional survey of 113 mothers of stunted children (0–59 months) was analysed with Structural Equation Modelling using Partial Least Squares (PLS-SEM). The model reveals significant positive paths from food security pillars to composite stunting prevention behaviours (β = 0.18–0.86, p < 0.05), with availability emerging as the strongest predictor. These findings highlight food security as a lever for reducing the local stunting prevalence (local 32% vs. national 24.4%) and provide evidence for community-based nutrition programmes in similar agrarian districts. Strengthening food security is therefore essential to safeguarding child well-being in vulnerable Indonesian communities. Full article

Clinical algorithms for child tuberculosis (TB) are a valuable guide for healthcare workers to initiate treatment. We evaluated the agreement of pediatric TB diagnosis using the current Indonesia diagnostic algorithms with the 2022 WHO treatment decision algorithm and developed a new Indonesia algorithm for child TB based upon our findings and expert opinion. We conducted a retrospective study at 10 hospitals in Indonesia, involving children (0–10 years), who were evaluated for TB diagnosis in 2022. A panel of child TB experts used participants’ records to make a diagnosis using the 2022 WHO algorithm and the 2016 Indonesian algorithm. We assessed agreement between the diagnosis made by the attending doctor and those determined by the expert panel. A new Indonesia guideline was developed based on the findings and consensus of various stakeholders. Of 523 eligible children, 371 (70.9%) were diagnosed with TB by the attending doctors, 295 (56.4%) by the WHO algorithm, and 246 (47%) by the Indonesia algorithm. The Cohen’s Kappa of TB diagnosis was: attending doctor vs. WHO algorithm (0.27), attending doctor vs. Indonesia algorithm (0.45), and WHO algorithm vs. Indonesia algorithm (0.42). A review of both algorithms revealed challenges for implementation. An algorithmic approach for child TB diagnosis may not be universally applicable or implementable due to variable access to diagnostic tests and the wide variety of clinical presentations. Full article

The consequences associated with pregnancy termination have garnered attention from healthcare professionals, particularly in Indonesia. However, national-level evidence on the factors driving pregnancy termination in Indonesia remains limited. This research aimed to identify patterns and characteristics associated with pregnancy termination among reproductive-age women in Indonesia. A cross-sectional study analyzed secondary data from the 2012 and 2017 Indonesian Demographic and Health Survey, involving women aged 15–49. The weighted sample included 42,269 individuals in 2012 and 47,001 in 2017. Binary logistic regression identified the correlates of pregnancy termination. Among 89,270 women of reproductive age, the prevalence of pregnancy termination was 12.68% in 2012 and 12.95% in 2017. Pregnancy termination was more frequently reported among women aged 44–49 years (adjusted odds ratio (AOR): 4.34, 95% confidence interval (CI): 3.54–5.33), those with secondary education (AOR: 1.29, 95% CI: 1.14–1.46), married women (AOR: 195.40, 95% CI: 114.70–332.90), employed women (AOR: 1.05, 95% CI: 1.00–1.09), individuals with health insurance (AOR: 1.07, 95% CI: 1.02–1.11), those who had experienced domestic violence (AOR: 1.07, 95% CI: 1.02–1.11), and regular television viewers (AOR: 1.10, 95% CI: 1.05–1.15). Conversely, pregnancy termination was less commonly reported among women with 1–2 living children (AOR: 0.80, 95% CI: 0.74–0.87), those who expressed no preference for having more children (AOR: 0.89, 95% CI: 0.84–0.94), and women using modern contraception (AOR: 0.76, 95% CI: 0.72–0.80). The findings revealed that the prevalence did not observe any changes in the incidence of pregnancy terminations between 2012 and 2017. Further evaluation by healthcare professionals is crucial to understanding the reasons behind pregnancy termination, especially among women of reproductive age. Insights into factors related to pregnancy termination, especially sociodemographic factors, can help mitigate the pregnancy termination in this population. Full article

Background: Stunting is a common issue affecting children who suffer from chronic malnutrition in Indonesia. The Indonesian government has introduced supplementary food programs for stunted children, but the results have been less satisfactory. This may be due to the presence of anaemia and comorbid diseases. Haematology tests and inflammation markers are necessary to identify these conditions. This study aimed to examine the anaemia profiles and inflammation markers in stunted children under two years old. Methods: A cross-sectional descriptive design with cluster samples and consecutive analysis was used. The study was conducted between December 2023 and March 2024 at the West Nusa Tenggara Hospital and Palabuhanratu Sukabumi Hospital laboratories. Samples were obtained from various Public Health Centres in Sukabumi, West Java, North Maluku, and West Nusa Tenggara. Data collection comprised interviews, measurements, and the assessment of haematology, biochemical, and inflammatory markers. Statistical analysis was conducted using SPSS version 20, which includes descriptive analysis, correlation, comparison, and chi-square tests. Results: Two hundred and ten stunted children were identified with various anaemias and comorbidities. These anaemias included suspected thalassemia (38.1%), iron deficiency (18.1%), and anaemia of chronic diseases (13.3%). Based on the inflammatory markers obtained, TB was suspected (21.4%), inflammatory bowel disease (18.1%) was suspected, and allergic proctocolitis was suspected (31.9%). Conclusions: Analysis of the anaemia profiles and inflammatory markers revealed various types of anaemia and suspected comorbidities in stunted children. It is recommended that anaemia profiles and inflammation markers be assessed at the primary healthcare level. Full article

Background: Routine childhood vaccination, e.g., for diphtheria, tetanus, and pertussis (DTP), might provide additional protection against SARS-CoV-2 infection. This concept of heterologous immunity was explored in healthy children receiving both DTP and inactivated SARS-CoV-2 vaccines. Methods: A cross-sectional study was performed on 154 healthy children aged 6–8 years old in Jakarta, Indonesia. Their vaccination status for the DTP (including a diphtheria–tetanus booster vaccine at 5 years old) and CoronaVac (from 6 years old) vaccines were recorded. Peripheral blood samples were collected from all participants, in which anti-diphtheria toxoid IgG and anti-SARS-CoV-2 S-RBD antibodies and T cell-derived IFN-γ were measured. Results: The study participants with complete DTP vaccination had significantly higher titers of anti-diphtheria toxoid IgG than the ones without (median = 0.9349 versus 0.2113 IU/mL; p < 0.0001). Upon stratification based on DTP and CoronaVac vaccination statuses, the participants with complete DTP and CoronaVac vaccinations had the highest titer of anti-SARS-CoV-2 S-RBD antibodies (median = 1196 U/mL) and the highest concentration of SARS-CoV-2-specific T cell-derived IFN-γ (median = 560.9 mIU/mL) among all the groups. Conclusions: Healthy children aged 6–8 years old with complete DTP and CoronaVac vaccinations exhibited stronger SARS-CoV-2-specific T cell immune responses. This might suggest an additional benefit of routine childhood vaccination in generating protection against novel pathogens, presumably via heterologous immunity. Full article

Parental labour migration, of either one or both parents, has been associated with various challenges among left-behind children (LBC). However, there is a limited understanding of the LBC’s own views and experiences of social and mental well-being and how the new daily life circumstances they encounter following their parents’ migration impact them. This study aimed to understand the influence of parental migration and its aftermath on the social and mental well-being of adolescents (referred to as LBC) in two rural districts in Indonesia. Employing a qualitative design, data were collected through individual in-depth interviews with LBC (n = 24) aged 14 to 18 years, recruited using the snowball sampling technique. Data were thematically analysed, guided by a qualitative data analysis framework. The findings showed that parental migration negatively impacted the social well-being of LBC. This impact was reflected in negative labelling from friends and changes in familial roles which influenced their social interactions and activities with peers. Parental migration was also associated with challenges to the mental well-being of LBC. These manifested in the LBC experiencing fractured emotional bonds, leading to negative emotions, including stress, anxiety, sadness, depression, frustration, loss of motivation, and self-imposed isolation, which were associated with their parents’ migration and abrupt disruptions in parent–child communication. The transition to new life situations with caregivers after parental migration and the dynamics within the caregivers’ households were additional factors that detrimentally affected their mental well-being. Unmet basic needs and educational needs due to financial hardships faced by mothers and caregivers further exacerbated mental health challenges for the children. The findings indicate the importance and improvement of policies and interventions in Indonesia (e.g., counselling services, non-cash food assistance, family hope program, direct cash assistance) that cover and address the diverse needs of mothers or caregivers and the LBC. Full article

This study investigates parents’ perceptions on school management practices for children with special educational needs in a small-sized Indonesian school. Data from surveys and interviews with 53 parents revealed overall positive attitudes toward classroom management and teacher care. However, concerns arose regarding teachers’ ability to support special needs students effectively, leading to hesitancy in collaborating for inclusive classrooms. To reorient parental perceptions to create conditions for successful inclusive education, effective communication strategies emphasizing teacher development and district-based support are crucial. Future research should focus on improving communication between parents to foster inclusive educational practices. These findings shed light on challenges and solutions for cultivating inclusive classroom environments in special education. Full article

In recent decades, the focus of health research has shifted to the impact of disease or impairment on how people proceed, behave, and experience quality of life. People’s lives are affected by oral diseases in various ways. Oral health-related quality of life (OHRQoL) is inextricably linked to general health and well-being, and it has far-reaching consequences for clinical practice and dentistry research. Particularly in Indonesia, increasing attention to OHRQoL is related to several concerning oral conditions, such as the extremely high number of cases of tooth decay and inflammation of dental supportive tissue that inexplicably lowers the population’s OHRQoL. To date, there has yet to be a bibliometric study of OHRQoL research in Indonesia. We intend to map the existing scientific literature on OHRQoL research in Indonesia during the last five years and investigate its research gaps. Scopus and the Sinta Database (a national database through Google Scholar) were used to retrieve Indonesian OHRQoL research publications from 2018 to 2023. Bibliographic data were analyzed using SPSS Statistics 25.0 and VOS Viewer 1.6.19. The data demonstrate that the number of OHRQoL-related publications in Indonesia and the number of local writers have increased over time. More of these publications were published in prestigious national journals than foreign ones. The study found that local researchers tended to conduct OHRQoL research on children and older populations, raising the issue of tooth decay or tooth loss. Exploring other subjects, such as dental anxiety, patient satisfaction, chewing performance, aesthetics, and appearance, and other populations (people with oral cancer and other systemic conditions) could broaden the environment of OHRQoL research in Indonesia. Full article

The prevalence of stunting in young children is associated with poor growth during the prenatal and early postnatal periods. A maternal mentoring program was developed for Indonesian women to improve birth outcomes. A cluster-randomized controlled trial (CRCT) was conducted in three sub-districts of the Special Region of Yogyakarta, Indonesia. A total of 384 eligible participants were randomly allocated to either an intervention (received the maternal mentoring program and standard care; n = 189) or control (received standard care only; n = 195) group. The maternal mentoring program provided preconception health education; health monitoring; and text message reminders for preconception women. Fetal growth was measured between gestational weeks 27 and 30 using the estimated fetal weight generated from ultrasonographic measurements. Birth weight was measured within 24 h of birth. A structured questionnaire captured women’s demographics, pregnancy readiness, and body mass indexes (BMIs). After adjustment, fetal weight was 14% (95% CI: 5.1–23.0) higher in the intervention group than in the control group, and the average weight-for-length Z-score at birth was 0.16 (95% CI: 0.04–0.30) higher in the intervention group than in the control group. The maternal mentoring program was associated with improved fetal growth and birth weight in this population and should be considered for scale-up to other settings, nationally and globally. Full article

Background: Childhood obesity is a major public health concern as it increases the risk of premature death and adult disability. Globally, the latest estimates showed that more than 340 million children and adolescents between the ages of 5 and 19 were overweight or obese in 2016. This study aimed to investigate the disparities in childhood overweight and obesity across 514 districts in Indonesia, based on geographic and socioeconomic factors. Methods: Geospatial and quantitative analyses were performed using the latest Indonesian Basic Health Survey data from 2018. Dependent variables were rates of overweight and obesity among children aged 5–17 years including by gender. Results: This study found that the rates of overweight were 17.2%, 17.6%, and 16.8% among all children, boys, and girls, while the rates of obesity were 7.0%, 7.9%, and 6.1%, respectively. Boys were 1.30 times more likely to be obese than girls, while overweight was similar between both sexes. Urban cities had significantly higher prevalence of childhood overweight and obesity compared with rural districts by up to 1.26 and 1.32 times, respectively. In addition, the most developed region had significantly higher prevalence of childhood overweight and obesity than the least developed region by up to 1.37 and 1.38 times, respectively. With regard to socioeconomic factors, our analysis demonstrated a notable disparity in the prevalence of childhood overweight and obesity across income quintiles. Specifically, the wealthiest districts exhibited a 1.18 times higher prevalence of overweight and obesity among all children compared with the poorest districts. This association was particularly pronounced among boys; in the richest quintile, the prevalence of overweight and obesity was 1.24 and 1.26 times higher, respectively, in comparison to the poorest income quintile. In contrast, district-level education appears to exhibit an inverse relationship with the prevalence of childhood overweight and obesity, although the findings were not statistically significant. Full article

Determinants of stunting are a concern in stunting locus villages, especially in East Nusa Tenggara, the province with the highest prevalence of stunting in Indonesia. This study aims to analyze the determinants of stunting in such villages. A cross-sectional research design was conducted on a sample of 166 mothers of children aged 24–59 months selected using a proportional random sampling method in four stunting locus villages in East Nusa Tenggara province, from January to March 2022. Chi-square and binary logistic regression were used to analyze the determinants of stunting with a significance level of p < 0.05. The prevalence of stunting among children aged below five years in the villages was 22.3%. Lack of maternal knowledge (AOR: 5.310; 95% CI: 0.671–41.997) and negative parenting (AOR: 3.026; 95% CI: 1.191–7.871) were associated with higher risk of stunting. Meanwhile, children aged below five years with close birth spacing (AOR: 0.304; 95% CI: 0.087–1.063) had a low risk of stunting. The prevalence of stunting in stunting locus villages needs special attention from the Indonesian government. Maternal knowledge should be enhanced by distributing information related to stunting through formal and non-formal education and teaching good parenting to reduce the prevalence of stunting among children aged below five years in stunting locus villages. Full article

Indonesians face serious health issues that arise from malnutrition, particularly in children who are under unfavorable dietary environments. The present study established a school meal program consisting of dietary and educational interventions and evaluated its impact on promoting continuous improvement in dietary behavior among junior and senior high school students in Indonesia. A total of 319 students belonging to an Islamic Boarding School participated in the pre-post intervention study for 9 months. All participants were assessed based on their Knowledge, Attitude, and Practice (KAP). A subgroup of 115 participants who were anemic and underweight was examined for dietary intake, nutrition status, and hemoglobin level. The KAP test scores for both nutrition and hygiene showed a significant increase for all students and the undernutrition group post-intervention. Protein, iron, and vitamin C intake significantly improved. Although there were no significant improvements in nutrition status, there was a significant increase in the hemoglobin level and a reduction in the prevalence of anemia from 42.6% to 21.7%. Thus, school meal program that combines dietary and educational interventions may effectively improve anemia in undernourished students as well as enhance the knowledge, attitudes, and practices related to health, nutrition, and hygiene in junior and senior high school students. Full article