Background: Chronic malnutrition in children is a severe global health concern. In Yogyakarta, the number of children who are too short for their age has dropped dramatically over the past few decades. Objective: To perform an analysis of trends, policies, and programs; and an assessment of government, community, household, and individual drivers of the stunting reduction in Yogyakarta, Indonesia. Method: Using a mixed-methods approach, there were three types of research: (1) analysis of quantitative data, (2) evaluation of stunting policy, and (3) focus group discussions and in-depth interviews to collect qualitative data. Results: The prevalence of stunting has decreased from year to year. Mean height-for-age z-scores (HAZ) improved by 0.22 SDs from 2013 to 2021. Male and female toddlers aged 20 months old. The COVID-19 pandemic has contributed to an increase in stunting-concurrent wasting. Nutrition-specific and -sensitive interventions have been carried out with coverage that continues to increase from year to year, although in 2020, or at the beginning of the COVID-19 pandemic, the coverage of specific interventions decreased. The government has committed to tackling stunting by implementing the five pillars of stunting prevention and the eight convergent stunting actions. As the drivers of stunting reduction, national and community stakeholders and mothers, at the village level, cited a combination of poverty reduction, years of formal education, prevention of early marriage, access to food, enhanced knowledge and perception, and increased access to sanitation and hygiene. Conclusions: Nutrition-specific and -sensitive sector improvements have been crucial for decreasing stunting in Yogyakarta, particularly in the areas of poverty reduction, food access, preventing child marriage, sanitation, education, and increasing knowledge and perception.

Background: Stunting is primarily a public health concern in Low- and Middle-Income Countries (LMIC). The involvement of Integrated Health Service Post (Indonesian: Posyandu) cadres is among the strategies to combat stunting in Indonesia. Objective: This study aimed to determine the effect of a short course on cadres’ knowledge. Method: A single group pre-test post-test design was conducted in Yogyakarta, Indonesia, from March to May 2022. Thirty cadres were selected based on the following criteria: willingness to participate, the number of stunted children in their Posyandu, able to read and write, and full attendance at the short course. The knowledge scores were measured by a questionnaire using true and false answers after a short course (post-test 1) and 4 weeks later (post-test 2). We apply STATA 16 to calculate the Mean Difference (MD) using a t-test and a Generalized Estimated Equation (GEE). Furthermore, the adequacy of the short course was evaluated with in-depth interviews. Result: GEE analysis showed that after controlling for age, education, occupation, and years of experience, the short course improved cadres’ knowledge significantly on post-tests 1 and 2, i.e., knowledge regarding Children Growth Monitoring (CGM) (Beta = 6.07, 95%CI: 5.10–7.03 and Beta = 8.57, 95%CI: 7.60–9.53, respectively), Children Development Monitoring (CDM) (Beta = 6.70, 95%CI: 5.75–7.65 and Beta = 9.27, 95%CI: 8.31–10.22, respectively), and Infant Young Children Feeding (IYCF) (Beta = 5.83, 95%CI: 4.44–7.23 and Beta = 11.7, 95%CI: 10.31–13.09, respectively). Furthermore, the short course increased their self-efficacy, confidence, and ability to assist stunted children through home visits. Conclusion: The short courses consistently and significantly boosted cadres’ knowledge of CGM, CDM, and IYCF, and appropriately facilitated cadres in visits to the homes of stunted children’s home.

Background: Stunting has been a public health problem in several developing countries including Indonesia. One of the strategies to reduce stunting was family assistance. This study was aimed to estimate the effect of family assistance by using an integrative nutrition package through home visits on the growth and development of stunted children. Method: This was an experimental study using pre-test post-test with control group design, conducted in Yogyakarta, Indonesia, on March to May 2022. The intervention group was provided an integrative nutrition package (INP) including maternal education, behavioral change through home visit, as well as monitoring children’s outcome, while the control group was asked to read and follow child care procedure in the maternal and child health (MCH) book as a standard procedure. Both groups were visited by trained health volunteers and had a complementary feeding (CF) package weekly for four weeks. The outcomes of this study were the maternal outcome (knowledge and behavior on children’s growth monitoring (CGM), children’s development monitoring (CDM), and infant/young children feeding (IYCF) as well as children’s outcomes, including body weight (BW), body height (BH), and child score development (CSD). This study used generalized estimating equation (GEE) to estimate the differences in differences (DID) of the impact of intervention compared with control group and compared among three different times (baseline, fourth, and eighth week). Results: There were 60 stunted children under five years in this study, i.e., 30 in intervention group and 30 in control group. From the GEE analysis, it was found that the regression adjusted DID showed statistically significant increase of all outcomes including children’s development score (CDS). The adjusted DID effect (95% CI) on 8th week for children’s weight, height, and development score were 0.31 (0.25–0.37), 0.41 (0.13–0.68), and −0.40 (−0.59–(−0.21)), respectively, among the intervention group. Conclusions: INP through home visit successfully increased maternal and children’s outcomes compared witsh standard procedure. The effect of intervention was found to be consistently significant in the fourth and eighth weeks after intervention. We recommend the local government to apply INP through home visit especially in high-prevalence stunting areas.

. Dengue Haemorrhagic Fever (DHF) is a major health problem in Tembalang sub district, Semarang City. Fogging with insecticide applications was done frequently as an effort to control Dengue vectors. The use of insecticides from the same class in a long time can lead to resistance in mosquitos’ population. The research aimed to observe the activity of monooxygenases in Aedes aegypti populations in Tembalang Subdistrict, Semarang. The study was conducted during February-November 2014 with a cross-sectional design in 10 villages in Tembalang Subdistirict, Semarang City. Field strains of Ae. aegypti eggs were collected using ovitraps. The collected eggs were grown under standard condition to adult mosquitoes. Mosquitos’ homogenate were stored at -85°C and used for biochemical assays. The results showed there was increased monooxygenases activity in Ae. aegypti populations. Resistance to synthetic pyrethroid insecticide in Ae. aegypti mosquitoes population in Tembalang Subdistrict might be caused by the mechanism of detoxification enzymes in particular monooxygenases Keywords: monooxygenase, insecticide, Ae. aegypti, resistance Abstrak. Demam Berdarah Dengue (DBD) masih menjadi masalah kesehatan utama di Kecamatan Tembalang, Kota Semarang. Tindakan fogging untuk pengendalian vektor DBD sering dilakukan. Penggunaan insektisida dari golongan yang sama dalam waktu cukup lama dapat memicu terjadinya resistensi. Tujuan penelitian untuk mengamati aktivitas enzim monooksigenase pada populasi nyamuk Aedes aegypti di Kecamatan Tembalang, Kota Semarang. Penelitian dilaksanakan bulan Februari-November 2014 dengan desain potong lintang di 10 desa di Kecamatan Tembalang, Kota Semarang. Pada penelitian ini dilakukan pemasangan ovitrap untuk mendapatkan sampel telur yang dipelihara menjadi nyamuk dewasa. Sampel homogenate nyamuk disimpan pada suhu -85°C, selanjutnya dilakukan peng-ujian resistensi dengan uji biokimia untuk melihat aktivitas enzim monooksigenase. Hasil pengujian menunjukkan terdapat peningkatan aktivitas enzim monooksigenase. Resistensi terhadap insektisida sintetik piretroid pada populasi nyamuk Ae. aegypti di Kecamatan Tembalang disebabkan oleh mekani-sme peningkatan enzim detoksifikasi khususnya monooksigenase. Kata Kunci: monooksigenase, insektisida, Ae. aegypti, resistensi

Murine typhus is a zoonotic infectious disease caused by Rickettsia typhi, whose transmission is carried out by rat fleas. The climatic and ecologic conditions in Banjarnegara is favorable for maintaining reservoirs and vectors of murine typhus. There has been no report about the occurrence of R. typhi in rat fleas. Therefore, we investigated the role of fleas as possible vector of murine typhus in Banjarnegara. During September to Nopember 2017, flea were collected from rats trapping of various habitat in Banjarnegara. Fleas preserved in 70% ethanol were eventually prepared onto slides for identification. Fleas of the same species were pooled by species of small mammal and habitat and then preserved in sodium chloride store at-20°C until evaluated for the presence of Rickettsia typhi by polymerase chain reaction. Two flea species were identified: Xenopsylla cheopis and Stivalius cognatus. Stivalius cognatus was collected from R. exulans and R. tiomanicus. Rickettsia spp. was detected in X. cheopis (45/88) and S. cognatus (3/11). The highest minimum infection rate of R. typhi was seen in X. cheopis infesting R. tanezumi in Kutabanjarnegara village (103.8). The presence of R. typhi in X. cheopis at residential area of Banjarnegara needs serious attention, as a form of awareness of disease transmission, especially murine typhus.

AbstrakMeluasnya kejadian resistensi pada vektor virus Dengue di Jawa Tengah memerlukan strategi pengelolaan resistensi insektisida secara efektif. Oleh karena itu, informasi mengenai mutasi gen pada posisi 1016 di domain II segmen ke­6 gen VGSC pada nyamuk Aedes aegypti yang menyebabkan perubahan asam amino valin (V) menjadi glisin (G) akan dapat memperkuat penelitian operasional mengenai strategi pemilihan insektisida dalam program­pengendalian­vektor­Dengue.­Penelitian­ini­menggunakan­uji­Allele-Specific­Polymerase­Chain­Reaction(AS­PCR) yang dapat mendeteksi mutasi V1016G. Sampel penelitian ini adalah 22 ekor nyamuk Aedes aegypti dari Kabupaten Klaten yang berumur 2­5 hari. Hasil penelitian menunjukkan bahwa 22,7% nyamuk belum mengalami mutasi (V/V), 59,1% nyamuk mengalami mutasi heterozigot (V/G) dan 18,2% nyamuk mengalami mutasi homozigot (G/G). Hal ini menunjukkan indikasi terjadinya resistensi populasi nyamuk Ae.aegypti terhadap insektisida sintetik piretroid yang disebabkan oleh mekanisme knockdown resistance.Kata Kunci:­Aedes­aegypti,­mutasi­V1016G,­Allele-Specific­PCR,­VGSCInsecticides resistance has spread rapidly among dengue vectors from Central Java, and require an effective insecticide resistance management strategies.one of the resistance mechanism in Aedes aegypti may arise through knockdown resistance or kdr which consists of single point mutation within the genes that are targeted by insecticide compounds. Mutation at position 1016 in domain II, segment 6 of the Voltage Gated Sodium Channel gene in Ae. aegypti leads to a valine to glycine substitution (V1016G) is associated with resistance to the type II pyrethroid. The result of this study will help us to strengthen basic and operational research on the­development­of­strategies­for­Dengue­vector­control­in­Indonesia.­This­study­utilized­an­allele-specificPolymerase Chain Reaction (AS­PCR) assay that could be used to detect the V1016G mutation. The assay was conducted on 22 female mosquitoes aged 2–5 days old. The result showed there were 22,7% wild type mosquito (V/V), 59,1% heterozygous for V1016G mutation (V/G) and 18,2% V1016G mutant homozygous (G/G). It indicated synthetic pyrethroid resistance in Ae.aegypti population caused by knockdown resistance mechanism.Keywords: Aedes aegypti,­V1016G­mutation,­Allele-Specific­PCR,­VGSC