OBESITY AND OUTCOME AMONG PATIENTS HOSPITALIZED FOR SARS-COV-2: A HOSPITAL-BASED STUDY IN INDONESIA.

Background: Patients with obesity who have SARS-CoV-2 are at significant risk for developing serious clinical problems that need intensive care and have a bad prognosis. Aim: The aim of this study was to determine obesity and outcome among patients hospitalized for SARS-CoV-2 at the Indonesia's national referral hospital. Methods: This study used a retrospective cohort. The study samples were SARS-CoV-2 patients who were treated by pulmonary specialists in the intensive room of Dr. M. Djamil Hospital Padang. The number of samples in this study was 106 subjects. Data analysis was performed using the Chi-square test, Kaplan-Meier, and Cox regression. P < 0.05 was significant, and the data were analyzed using the SPSS version 21.0 program. Results: The results of this study found obesity was associated with the outcome of SARS-CoV-2 patients treated at Indonesia's national referral hospital (p<0.05, OR=3.55 (95% CI 1.44-8.71)). The mortality rate among patients hospitalized with SARS-CoV-2 at Indonesia's national referral hospital with obesity was higher than non-obese; 82.7% and 57.4% respectively. The length of stay in patients with obesity was also shorter; 12 days compared to 19 days in non-obese. Conclusion: There was an association between obesity with mortality of SARS-CoV-2 patients in a national referral hospital in Indonesia. This study can provide input in the therapeutic management of patients with obesity so as to reduce the poor prognosis.

Factors driving and inhibiting stunting reduction acceleration programs at district level: A qualitative study in West Sumatra.

Stunting prevalence varies significantly across Indonesian provinces and districts/municipalities, including West Sumatra. This research aims to identify the driving and inhibiting factors for implementing the stunting reduction acceleration program at the district level in West Sumatra. The research was conducted in 2022 with a qualitative study design and a case study approach. Data were collected through (i) group interviews with key informants involving policymakers and program managers at the provincial, district, sub-district, and village levels and (ii) in-depth interviews with mothers of stunted children. Two districts were selected as research sites. One district represents an area that has yet to be developed (District A or failed district). The other district has seen a significant reduction in the prevalence of stunting (District B or successful district). We found several driving and inhibiting factors that affect the reduced prevalence of stunting, such as the need for the relevant agency to play a strong role as the leading and responsible sector for stunting convergence actions. Another important factor is paying close attention to improving the quality of stunting data and providing adequate funding support. High commitment from Public Health Centers to maternal health through classes for pregnant women, infants, and children under the age of five can also have an impact. Furthermore, properly performing duties by assigned actors in specific and sensitive programs and integrated monitoring and evaluation of program implementation and outcomes can influence stunting prevalence. Recommendations for accelerating stunting reduction include improving communication and coordination, establishing stunting prevalence reduction as a performance indicator among the related district government and its various agencies, and assisting the village administration with planning and budgeting to support stunting prevention.

Monitoring continuity of maternal and child health services, Indonesia.

OBJECTIVE: To implement an online system to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on maternal and child health and nutrition essential health services in Indonesia. METHODS: We developed an electronic monitoring and evaluation system to assist district health offices in making rapid assessments of the impact of COVID-19 on maternal and child health and nutrition programmes in their area and in developing policy and programme responses. This implementation research was conducted from September to December 2020 in 304 districts. The strategies consisted of technical assistance for district offices by 21 partner universities and development of an online dashboard for rapid situation analyses and reporting. We collected qualitative data on feasibility and adherence to the intervention, as well as quantitative data from routine health databases to analyse the impact of COVID-19 on maternal and child health and nutrition indicators. FINDINGS: In the majority of districts key maternal and child health and nutrition services were moderately or severely affected by the pandemic, particularly child growth monitoring and antenatal care services. Adherence to the protocol of the intervention varied across districts but the system is a feasible approach to be scaled up to other regions and health programmes. High uptake by the health ministry, district office and university partners provided the platform with collaborative efforts for health-systems strengthening. CONCLUSION: The electronic monitoring and evaluation system could be implemented and completed with several modifications to accommodate district offices and universities. There is a potential to scale up the intervention with better implementation planning and training.

Children's Perception and Belief about Medicines: Effectiveness and Its Autonomy.

BACKGROUND: The use of medicines in children is usually always under the supervision of parents. Children are considered not to understand the concept of medicine properly. Children's perceptions of medicine are mostly formed from everyday experience. This can have an impact on children's beliefs about medicines which they are also required to be active and rational medicine users. AIM: This study aims to look at children's perceptions and beliefs about medicines, especially in the perspective of medicine efficacy and children's autonomy in using them. METHOD: The study was conducted with an analytical method with a cross-sectional approach using a questionnaire instrument in grade V elementary school children in Padang City, Indonesia. The total sample size obtained was 503 students. RESULTS: Children still think that medicine efficacy is influenced by taste, colour, size, medicine price, a place to buy medicine and how to get medication. 10.1% of children have stored the medicine at home, and 48.5% of children always depends on waited for their parents when they wanted to take medicine. Regarding children's access to medicines, 11.5% of children have bought their own over-the-counter medicine to a pharmacy or medicine store without the parents' knowledge. 31.4% of children have taken medicine at home without the parents' knowledge. CONCLUSION: The results of this study indicate that children's perceptions of medicine efficacy are still very limited. Even though the child has used the medicine alone in a limited way, the child's autonomy in using the medicine still needs to be monitored by the parent. Therefore, this is the reason for the need for medical education given to children, especially in schools as an integral part of health education.

The Difference in Maternal Serum Hypoxia-Inducible Factors-1α Levels between Early Onset and Late-Onset Preeclampsia.

BACKGROUND: Preeclampsia can be divided into early (EOPE) and late (LOPE) onset preeclampsia. Preeclampsia is related to the failure of placentation. Accumulation of hypoxia-inducible factors (HIF)-1α is commonly an acute and beneficial respond to hypoxia, while chronically elevated is associated with preeclampsia. AIM: This study aims to evaluate the serum levels of HIF-1α in preeclampsia and normal pregnancy, and to compare the difference between early-onset and late-onset preeclampsia. METHODS: A cross-sectional comparative study was conducted among a total of 69 pregnant women at ≥ 20 weeks of gestation, were recruited at obstetrics and gynaecology department at Dr M. Djamil Padang Hospital, network hospitals, health centres. They were divided into three groups early-onset preeclampsia, late-onset preeclampsia, and normal pregnancy. Preeclampsia was diagnosed using International Guidelines. Data were analysed by SPSS 24 program; data are presented as median and range or as mean ± standard deviation. One-way ANOVA test was used to determine the relationship between HIF-1α levels with the onset of preeclampsia. RESULTS: The results showed that the mean maternal serum HIF-1α levels in early-onset preeclampsia (EOPE), late-onset preeclampsia (LOPE), and normal pregnancy were 1366.96 ± 733.40 pg/ml, 916.87 ± 466.06 pg/ml, and 716.77 ± 541.08 pg/ml. Serum HIF-1α levels were higher in early-onset preeclampsia (EOPE), and late-onset preeclampsia (LOPE) compared to normal pregnancy. Among preeclampsia patients, serum HIF-1α was higher in EOPE than LOPE women. Statistical analysis revealed a significant difference in mean maternal serum HIF-1α between early-onset preeclampsia, late-onset preeclampsia, and normal pregnancy (p < 0.05). CONCLUSION: This study concluded that there is a significantly different level of HIF-1α between in early-onset preeclampsia, late-onset preeclampsia and normal pregnancy. Early-onset preeclampsia is the highest levels of serum HIF-1α.

The Knowledge and Attitudes about the Benefits, Risks and Use of Medicine in Aged Primary Students in Indonesia.

BACKGROUND: Medication always has a ratio of benefits and risks to become a safety measure. Therefore, its use must be careful, especially for children, because it can potentially occur drug incidents in children. As drug users, children are required to be active in using it, but children's knowledge and attitudes about benefits, risks (dangers) and use of medicine are still very shallow and fragmented. AIM: This study aims to look at the description of children's knowledge and attitudes about medicine from the perspective of the benefits, risks or dangers and use of medicine and the factors that influence them. MATERIAL AND METHODS: The study was conducted by the analytic method with a cross-sectional approach using a questionnaire instrument in grade V elementary school-age children in Padang City, Indonesia. The total sample size obtained was 503 students. RESULTS: The results showed that children's knowledge of medicine was generally categorised as low, with an average score of 4.70 (SD 1.82) from a scale of 9. Knowledge of drug use was much lower, namely the average score of 1.21 (0.74), followed by knowledge of drug hazards an average score of 1.69 (1.03) and drug benefits an average score of 1.80 (0.69). Age variables, address of residence, family income, the existence of families working as health workers and sources of drug information significantly influence students knowledge (P < 0.05). Whereas students attitudes towards medicine tend to be more positive with an average score of 7.18 (1.77), where the average score of attitudes towards benefits, risks (hazards) and drug use are 1.79 (0.46), respectively, 1.10 (0.58) and 4.29 (1.37). Address of residence, companion during illness, achievement in school and experience in hospital care have a significant effect on student attitudes (P < 0.05). CONCLUSION: This study concluded that indicate that students knowledge of benefits, risks and use of medicine is still low and very limited. While related to student attitudes, in general, it tends to be more positive, except about the dangers of medicine that show a negative attitude. The low level of knowledge and limited attitudes of children are the reason for the need for drug education given to children, especially in schools as an integral part of health education.

Dietary Fibre Protective against Colorectal Cancer Patients in Asia: A Meta-Analysis.

BACKGROUND: The association between dietary fibre and colorectal cancer risk is controversial. AIM: This systematic review and meta-analysis were performed to determine the dietary fibre protective against colorectal cancer patients in Asia. METHODS: The authors conducted a meta-analysis of published research articles on dietary fibre protective against colorectal cancer patients in Asia published between January 2000 and March 2019 in the online article databases of PubMed, ProQuest and EBSCO. Pooled odds ratios (OR) were calculated with fixed and random-effect models. Publication bias was visually evaluated by using funnel plots and statistically assessed through Egger's and Begg's tests. Data were processed using Review Manager 5.3 (RevMan 5.3) and Stata version 14.2 (Stata Corporation). RESULTS: This study reviewed 405 articles. There are 10 studies conducted a systematic review and continued with Meta-analysis of relevant data with several sample 49,964 patients. The results showed dietary fibre protective against colorectal cancer patients in Asia (OR = 0.66 [95% CI 0.56-0.77, p=0.008]). There was significant publication bias for studies included in dietary fibre protective against colorectal cancer patients in Asia. CONCLUSION: This analysis confirmed dietary fibre protective against colorectal cancer patients in Asia.