The primary objective of this study was to determine the effect of a training intervention in overall improvement in students’ (santris) knowledge, behavior, and outcome. A mixed-methods exploratory sequential design was applied. First, qualitative data were collected from three focus group discussions with 20 supervisors and one in-depth interview with school principal to explore current hygiene practices. The information was then used to develop training intervention using either video, poster, and leaflet. To measure the effect, a stepped wedge cluster design with pre- and post-test analyses was conducted. A total of 452 junior high school santris in one Islamic boarding school were non-randomly allocated to either three intervention groups. Outcome measures were knowledge, personal behavior, and room hygiene. Codes and categories were produced in the qualitative analysis, while paired t-tests and Wilcoxon rank tests test were used in the quantitative analysis. The qualitative study identified poor practices on personal and room hygiene among the santris and proposed a training intervention. Overall, there was a significant increase in knowledge and personal behavior after the intervention (7.22 ± 1.34 pre-intervention to 7.70 ± 0.74 post-intervention and 9.75 ± 2.98 pre-intervention to 12.16 ± 2.12 post-intervention, respectively, p < 0.001). Room hygiene was significantly improved among boys and those who received leaflets. Having developed a specific training materials, school-based hygiene training intervention improved knowledge and personal behavior. Its effect on room hygiene particularly for female santris needs further strengthening of the intervention in this Islamic boarding school setting.

Stroke is the world's second largest cause of mortality and the leading cause of disability. The report of incidence and prevalence of stroke by cause in Indonesia based on national population was limited. The objective of this study was to explore the incidence and prevalence of stroke and cause of stroke by province, sex, and age categories in Indonesia. The causes of stroke in Indonesia, including each province, were collected from the Global Burden of Disease study (GBD) 2019. The age-standardized incidence rates and age-standardized prevalence rates per 100,000 individuals with 95% Uncertainty Intervals (UIs) were used to estimate the incidence and prevalence characteristics. The cause of stroke was classified into three types: intracerebral hemorrhage, ischemic stroke, and subarachnoid hemorrhage. In 2019, the national incidence and prevalence of stroke in Indonesia were 293.33 (262.2 – 331.6 95% UIs) and 2,097.22 (1878.2 – 2351.8 95% UIs) per 100,000 individuals, respectively. East Kalimantan province holds the highest rank in the incidence rate of stroke and ischemic stroke as well as the prevalence rate for almost all types of stroke, except for subarachnoid hemorrhage, which Yogyakarta holds. Meanwhile, the highest incidence rates for intracerebral hemorrhage and subarachnoid hemorrhage were in the provinces of South Kalimantan and North Maluku, respectively. Females and over 70 years of age had a higher incidence and prevalence of stroke than other groups.

Introduction: Chronic energy deficiency (CED) significantly impacts maternal health and child development. Socioeconomic conditions and access to health services cause young mothers in rural areas to have different health problems from those in urban areas. The study aimed to analyze the factors associated with CED among young pregnant women in rural areas in Indonesia. Methods: Secondary data for this cross-sectional study were obtained from the 2018 Basic Health Research Survey. One thousand one hundred and thirty-nine pregnant women aged <25 years were involved as subjects. Age, number of family members, education, occupation, gravida, abortion, supplementary feeding, and iron tablets during pregnancy were included as independent variables. Binomial logistic regression analysis was performed to measure the association between the independent and dependent variables. The strength of the association was expressed by p-value <0.05. Results: The three factors associated with CED were age (p=0.001), education (p=0.013), and supplementary feeding (p<0.001). Conclusions: Equitable education, increasing the age at which moms can become pregnant, and efforts to fulfill the nutrition needs of pregnant women by providing supplemental food based on community empowerment are significant. Family and community involvement will ensure the sustainability of this CED prevention program.

As an endocrine disruptor chemical, pesticide exposure may affect the regulation of growth hormones such as insulin-like growth factor-1 (IGF-1). A few current studies to date have noted that long-term pesticide exposure disrupted IGF-1, a potential risk of stunting in children. This study aims to evaluate studies to date of the effect of pesticide exposure on stunting incidence. This systematic review and meta-analysis adhered to the PRISMA (Pre-ferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. The PubMed and EBSCO databases were searched for relevant articles without publication restrictions. This review aimed to include reviews, randomized controlled trials (RCT), and cohort, case-control, and cross-sectional studies, which provide actual exposure types of pesticides with stunting measurement by height-age z score. A screening, extraction, and synthesis were conducted, leading to a consensus for reaching mutual agreement. The analysis was performed using Microsoft Excel 2017 for the screening and extraction, Revman version 5.4 software for the meta-analysis, and OpenMEE software for the meta-regression. Of the 13 studies subjected to the qualitative analysis, 6 were eligible for inclusion in the meta-analysis: 2 reviews, 2 RCTs, 2 cohorts, 2 case-control, and 5 cross-sectional studies. Exposure to organophosphate and pyrethroid pesticides was not associated with stunting (P=0.78; odds ratio [OR], 1.11; 95% confidence interval [CI], 0.65–1.88). Heterogeneity existed for 79% of the meta-analysis (P≤0.000; z=-5.37; 95% CI, -0.034 to -0.016), and the meta-regression identified age as the causative covariate. Pesticide exposure, regardless of type, is not associated with stunting in children.

Preventive policies and mobility restrictions are believed to work for inhibiting the growth rate of COVID-19 cases; however, their effects have rarely been assessed and quantified in Southeast Asia. We aimed to examine the effects of the government responses and community mobility on the COVID-19 pandemic in Southeast Asian countries. The study extracted data from Coronavirus Government Response Tracker, COVID-19 Community Mobility Report, and Our World in Data between 1 March and 31 December 2020. The government responses were measured by containment, health, and economic support index. The community mobility took data on movement trends at six locations. Partial least square structural equation modeling was used for bi-monthly analyses in each country. Results show that the community mobility generally followed government responses, especially the containment index. The path coefficients of government responses to community mobility ranged from −0.785 to −0.976 in March to April and −0.670 to −0.932 in May to June. The path coefficients of community mobility to the COVID-19 cases ranged from −0.058 to −0.937 in March to April and from −0.059 to −0.640 in September to October. It suggests that the first few months since the mobility restriction implemented is the optimal time to control the pandemic.

Introduction: COVID-9 is a global pandemic and causes changes in behavior and life. The implementation of health protocols is the most important aspect to prevent the transmission of COVID19, especially in the Islamic boarding schools (Pondok Pesantren) community. The aim of this study is to identify the practice of a clean and healthy lifestyle as well as the application of health protocols in the Pondok Pesantren to control the spread of COVID-19. Methods: The preliminary survey was conducted as a part of training for the healthy student cadre and the establishment of COVID-19 shelters in Pondok Pesantren in The Special Region of Yogyakarta, Indonesia. Fourteen questions including the name of Pondok Pesantren and multiple-choice questions related to clean and healthy living behaviors comparison before and during the pandemic, health protocol implementation during the pandemic, and provision of COVID-19 prevention and control program. Results: Total sample consisted of 84 students from 18 Pondok Pesantren in The Special Region of Yogyakarta. Among the factors affecting the student’s compliance with health protocol implementation in Pondok Pesantren were the disparity of individual’s understanding and obedience to rules and regulations regarding health protocol implementation (71,8%), inadequate facilities (12,8%), and other factors including that there was no strict supervision and punishment for violation upon regulations. Conclusion: Pondok pesantren is an institution that needs more attention amid the pandemic of COVID-19. Dense population, minimum infrastructure, and relatively poor access to healthcare facilities have made them a vulnerable community.