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31,456 Article Results

Tacrolimus outcomes in adult kidney transplants: a decade review

10.11591/ijphs.v15i1.26879
Lolita Lolita , Isrovanigoro Isrovanigoro , Metalia Puspitasari , Zijie Wang
Tacrolimus remains a principal immunosuppressive agent in kidney transplantation, yet its reported efficacy and safety vary due to differences in study design, treatment regimens, and patient characteristics. Objectives: To summarize recent evidence on the clinical performance of tacrolimus in adult kidney transplant recipients and identify factors contributing to variability in outcomes. A narrative review was conducted using PubMed as the primary database because of its comprehensive indexing of clinical and pharmacological studies relevant to transplant immunosuppression. Additional databases were screened to ensure completeness. Studies published between 2015 and 2025 were searched using predefined keywords. Of 91 open-access articles identified, 19 met the inclusion criteria and were analyzed. Results: Reported clinical outcomes demonstrated wide variability across studies. Acute rejection ranged from 0-18.8%, while biopsy-proven acute rejection varied substantially (0-85%). Graft loss occurred in 0-15% of recipients and mortality in 0-8%. Major adverse events were also heterogeneous, including cytomegalovirus (CMV) infection (0-16.9%), new-onset diabetes after transplantation (NODAT) (0-22.8%), and tremor (3-28.6%). Variability in findings was largely influenced by differences in study methodology, concomitant immunosuppressive protocols, monitoring practices, population characteristics, and limited ethnic diversity, as most participants were Caucasian. Tacrolimus maintains a strong efficacy-safety profile in adult kidney transplantation. Future studies with more diverse populations, standardized therapeutic drug monitoring, and longer follow-up durations are required to enhance generalizability and support individualized immunosuppressive management.
Volume: 15
Issue: 1
Page: 57-71
Publish at: 2026-03-05

Analysis of the implementation of the healthy Indonesia program policy with a family approach

10.11591/ijphs.v15i1.26855
Abdul Haris , M. Rizki Aditya
This study evaluates the implementation of the Healthy Indonesia Program Family Approach to improve public health and identify inhibiting and supporting factors. This qualitative research employs a case study approach to investigate healthcare dynamics at the Tambora Community Health Center in Bima City, Indonesia. Twelve informants were purposively selected. Data collection involved in-depth interviews, direct observation, and document review, allowing for a multifaceted perspective. An interactive analysis model by Miles and Huberman was used for data analysis, incorporating data collection, reduction, and presentation iteratively. Results showed that 85% of implementing staff had been trained, but there was a shortage of field surveyors, and family visit coverage only reached 72%, below the national target of 80%. Although the average healthy family index of 0.65 indicates adequate results, the main challenges lie in clean living behavior and nutritious diets. The program for mothers giving birth in health facilities reached 95%, but awareness of improving the management of chronic diseases, such as hypertension and tuberculosis, remained low, with treatment fulfillment at 65% and 70%, respectively. The conclusions highlight the need for adaptation strategies and continuous evaluation for the Healthy Indonesia Program to be successful across communities.
Volume: 15
Issue: 1
Page: 232-241
Publish at: 2026-03-05

Effects of soy plus zinc supplementation on growth and kidney health in Wistar rats: Implications for childhood stunting prevention

10.11591/ijphs.v15i1.26895
Yuniastini Yuniastini , Purwati Purwati , Antun Rahmadi , Sulastri Sulastri , Wien Wiratmoko , Iradah Lia Prasetio , Hendri Busman , Muhammad Al Hafidz , Fannia Khairani Mz , Mohammad Hafid Hak
Zinc deficiency can cause growth and health problems, whereas protein from soy sources contributes to essential nutritional intake. This study aimed to evaluate the effects of soy plus zinc (SPZ) supplementation on growth and kidney health in Wistar rats. This study used a randomized controlled trial design with 24 rats divided into five treatment groups, including a control group. SPZ supplementation was administered daily for 14 days with varying zinc doses (0.020 mg and 0.035 mg per gram of body weight) and palatability enhancement using vanilla flavoring. Data obtained through measurements of initial and final body weights and kidney weights were analyzed using ANOVA to determine significant differences between groups. The results showed that SPZ supplementation positively contributed to growth, as evidenced by a significant increase in the final weight of rats compared to their initial weight (p < 0.05). Histological analysis of the kidneys indicated no visible structural damage, and the average increase in kidney weight was approximately 26.5%. The combination of soy and zinc in SPZ was shown to have a synergistic effect that benefits the development and kidney health of rats, demonstrating its potential application in the context of animal nutrition.
Volume: 15
Issue: 1
Page: 140-149
Publish at: 2026-03-05

Emotional experiences of Indonesian health science students with self-harm: a phenomenological study

10.11591/ijphs.v15i1.26841
Meidiana Dwidiyanti , Geovanny Serviam Permana Putri Rahamitu , Luky Dwiantoro , Nur Setiawati Dewi , Sri Padma Sari , Alifia Dian Yusriana
Health students often face academic pressure and interpersonal conflicts that can affect their emotional regulation, thereby increasing the risk of self-harm behavior. This study aimed to explore the emotional experiences of health students who have engaged in self-harm through a phenomenological approach. A total of 8 participants (aged 18-25 years) who had engaged in self-harm and came from various health study programs participated in in-depth interviews lasting 45-70 minutes. The results of the study reveal three main themes: i) psychosocial stress as a trigger for negative emotions, ii) the role of social support in the recovery process, and iii) coping mechanisms and the need for professional intervention. These findings reveal emotional dynamics that have not been widely explored in the context of health students in Indonesia, particularly how self-harm is perceived as a strategy to control excessive emotional intensity. This study makes a new contribution by highlighting the need for interventions based on emotional regulation and increased social support that are appropriate to the subjective experiences of health students. Interventions based on empathy and psychological approaches that are more sensitive to the cultural context of the campus are the main recommendations.
Volume: 15
Issue: 1
Page: 283-296
Publish at: 2026-03-05

Sex differences on patient safety culture practices among nurses in Karawang, Indonesia: a cross-sectional study

10.11591/ijphs.v15i1.22681
Lilis Suryani , Santhna Letchmi , Faridah Mohd Said
Nurses are critical in enhancing the quality of care and patient safety due to their commitment to caring for patients 24 hours a day and their interaction with families and other health professionals. The role of gender in the interprofessional team is more complex and warrants further investigation, even though it has been increasingly studied at the level of the individual healthcare provider. In this study, we examined sex differences in patient safety culture practices among nurses. This study was conducted using a cross-sectional design at a general public hospital in Karawang, West Java, Indonesia. The hospital survey on patient safety culture (HSPSC) was used. A chi-square test and an independent t-test were used to determine whether there were any differences in patient safety culture practice between the sexes. A total of 75 males and 145 females agreed to join this study. The mean age of female and male participants was 34.21 ± 14.07 and 36.29 ± 12.51 years old, respectively. Age, marital status, and working position were significantly different between males and females (p < 0.05). Females reported to have a higher overall score of patient safety culture practices than males (3.65 (SD = 1.12 vs. 3.11 (SD = 1.43), p-value = 0.001). According to the patient safety culture practice domain, teamwork (4.21 (SD = 1.35) vs. 3.78 (SD = 1.76), p-value = 0.001), response to error (3.56 (SD = 1.93) vs. 3.31 (SD = 1.93), p-value = 0.001), and communication openness (3.881.56 vs. 2.35 (SD = 0.92), p-value = 0.001) were higher among female than male. Nurses must be trained, and professional communication must be improved as a means of ensuring better patient safety. Patient safety cultures vary widely across hospitals, units, and countries, as evidenced by the growing number of studies that have looked at this issue in depth.
Volume: 15
Issue: 1
Page: 126-131
Publish at: 2026-03-05

Nipah virus as an emerging threat: mutational dynamics, pathogenesis, and advances in vaccine development- a systematic review

10.11591/ijphs.v15i1.22365
Sadia Afrin , Md. Rezwan Ahmed Mahedi , Asma Akhter Radia , Joti Devi
Nipah virus (NiV) is an emerging zoonotic pathogen with significant pandemic potential. Large outbreaks, such as in Malaysia, required the culling of over one million pigs to control transmission. However, the epidemiology of NiV among animal hosts, including pigs, horses, and bats, remains incompletely understood. NiV infection primarily affects the respiratory and nervous systems, causing severe pneumonia, vasculitis, and meningitis, while encephalitis may be mild or infrequent in some cases. This systematic review summarizes current evidence on NiV mutational variation, pathogenesis, treatment strategies, and vaccine development up to 2022. Data were collected from major databases, including PubMed, PMC, and Cochrane Library. Due to limited therapeutic options, NiV management relies mainly on supportive care, as no approved vaccines or specific antiviral treatments are available for humans or livestock. Preventive strategies focus on reducing zoonotic transmission, particularly by minimizing contact between livestock and bat-contaminated food sources, and improving farm management practices. Early detection and continuous surveillance of high-risk populations and animal reservoirs are essential for outbreak control. Current vaccine research targets viral antigens using subunit and vector-based approaches. Overall, further studies are urgently needed to develop effective vaccines and antiviral therapies for NiV infection.
Volume: 15
Issue: 1
Page: 197-207
Publish at: 2026-03-05

Association between anemia, mental health, and nutritional status among junior high school students: a cross-sectional study in Pontianak

10.11591/ijphs.v15i1.26843
Agustina Arundina Triharja Tejoyuwono , Iit Fitrianingrum , Desriani Lestari
Iron deficiency can affect emotional regulation and contribute to symptoms of anxiety, stress, and depression. Poor dietary habits combined with mental health problems may further increase the risk of anemia. This study examined the association between anemia, mental health, and nutritional status among junior high school students in Pontianak. A cross-sectional design was used from May to December 2024 involving 277 students. Data were collected using body mass index (BMI) measurements, hemoglobin screening, and the DASS-Y questionnaire, and were analyzed with Spearman’s Rho. Most respondents were female (63.9%), and 90.96% had experienced menstruation. A total of 103 students were underweight, with an average mid–upper arm circumference of 21.48 cm, indicating chronic nutritional risk. Eighty-one students (29.2%) had anemia, predominantly females. Most students had good mental health (below the 50th percentile). No significant associations were found between anemia and mental health (p = 0.623) or between anemia and nutritional status (p = 0.664). Despite the lack of significant relationships, ongoing nutrition education, regular iron supplementation, counseling support, and routine monitoring of students’ nutritional and mental health remain important to maintain and improve overall wellbeing.
Volume: 15
Issue: 1
Page: 171-178
Publish at: 2026-03-05

Mental health status of healthcare workers in COVID-19 vs non-COVID-19 units: findings from Shariati Hospital, Tehran

10.11591/ijphs.v15i1.23419
Abdolhakim Jorbonyan , Maryam Khosrozadeh , Ali Karimi-rozveh
This cross-sectional study compared the mental health status of healthcare workers in COVID-19 and non-COVID-19 wards at Shariati Hospital, Tehran, Iran. A total of 250 healthcare workers were selected via systematic random sampling and completed the 28-item General Health Questionnaire (GHQ-28). Data were analyzed using descriptive and inferential statistics in SPSS 24.0. Participants had a mean age of 35.5 years (SD = 8.28) and included 52.6% females and 47.4% males. Based on a GHQ score >23, 63 (53.3%) of staff in COVID-19 wards and 51 (44.7%) in non-COVID-19 wards were suspected of having some degree of mental health disorder. Independent t-test results indicated that healthcare workers in COVID-19 wards experienced significantly higher levels of general mental health problems (t = 4.20, P < 0.001), anxiety (t = 5.55, P < 0.001), and somatic symptoms (t = 4.09, P < 0.001) compared to their counterparts in non-COVID-19 wards. The study highlights a relatively high prevalence of mental health disorders among hospital staff, particularly those working in COVID-19 units. Early identification of at-risk personnel, implementation of targeted interventions, and provision of counseling and psychological support are essential to safeguard the mental well-being and performance of healthcare workers during the ongoing pandemic.
Volume: 15
Issue: 1
Page: 1-7
Publish at: 2026-03-05

Antibiotic susceptibility profile of uropathogens in pregnant women with asymptomatic bacteriuria in tertiary care hospital: a cross-sectional study

10.11591/ijphs.v15i1.26813
K. Murugesh , Harvick P. Gowda , K. Pushpalatha , J. V. Sathish
Urinary tract infections (UTIs) are common during pregnancy due to physiological and anatomical changes that predispose women to infections. One such condition, asymptomatic bacteriuria (ASB), if left undiagnosed and untreated, can lead to serious maternal complications such as pyelonephritis, postpartum UTI, and hypertensive disorders, as well as neonatal complications including preterm birth, low birth weight, and intrauterine growth restriction. This study aimed to determine the prevalence of ASB, identify the major uropathogens, and analyze their antibiotic susceptibility patterns in pregnant women, to guide effective antenatal care and treatment. This cross-sectional study was conducted on 100 midstream urine samples, which were cultured using standard microbiological techniques. The bacterial isolates obtained were identified, and their antibiotic susceptibility was determined following standard guidelines. Out of 100 samples, 14 (14%) were positive for significant bacteriuria. The most common isolates were Staphylococcus aureus (42.8%), followed by Escherichia coli (28.6%) and Klebsiella species (28.6%). ASB was most prevalent in women aged 21-30 years (64.3%), during the first trimester (64.2%), and among multigravida women (57.2%). The isolated organisms showed good susceptibility to Ceftazidime/Clavulanic acid, Ciprofloxacin, Vancomycin, Amikacin, Piperacillin–Tazobactam, Imipenem, Teicoplanin, and Linezolid. Early detection and treatment can significantly reduce adverse outcomes, making bacteriuria screening an essential part of routine antenatal care.
Volume: 15
Issue: 1
Page: 132-139
Publish at: 2026-03-05

Acute and chronic lead exposure and intelligence quotient among Indonesian adolescents: a cross-sectional study

10.11591/ijphs.v15i1.26914
Noviana Dewi , Indah Tri Susilowati
Lead exposure is a persistent environmental health concern that can impair cognitive function in adolescents. Therefore, this study aims to examine the association between acute and chronic lead exposure and intelligence quotient (IQ) scores among Indonesian adolescents. A cross-sectional study was carried out involving 39 adolescents who were chosen through purposive sampling. Acute exposure was assessed using blood lead levels(n = 15), while chronic exposure was evaluated with hair lead levels(n = 24). IQ was measured using WAIS administered by a licensed psychologist, while associations between the variables were examined utilizing the Chi-square test. The results revealed that chronic lead exposure was significantly linked to below-average IQ (OR = 1.90; 95% CI: 1.07-3.36), while acute exposure had a weaker relationship (OR = 0.35; 95% CI: 0.13-0.89; p = 0.022). These results indicated the importance of long-term environmental exposure control.
Volume: 15
Issue: 1
Page: 208-215
Publish at: 2026-03-05

Causes and risk factors of neonatal mortality through the AMP-SR framework: a scoping review in Indonesia

10.11591/ijphs.v15i1.26918
Sulicha Nurhayati , Martha Irene Kartasurya , Cahya Tri Purnami
Neonatal mortality in Indonesia continues to increase, especially during the first 0-6 days of life, indicating persistent gaps in the quality of maternal and neonatal care. The maternal perinatal surveillance and response audit (AMP-SR) is implemented to identify causes of death and guide preventive and curative actions. This scoping review aims to explore the causes and risk factors of neonatal mortality using the AMP-SR framework. Article searches were conducted in Google Scholar, Garuda, and PubMed using the keywords (“Neonatal Death” OR “Cause of Death” OR “Kematian Neonatal”) AND (“AMP-SR” OR “Death Notification”). Inclusion criteria comprised primary studies published in Indonesian or English between 2021 and 2025 that examined neonatal deaths using the AMP-SR approach. Seventeen articles were selected and thematically analyzed following the PRISMA guidelines. The main causes of neonatal death were clinical conditions, including asphyxia, prematurity, sepsis, hypothermia, and congenital abnormalities. Identified risk factors encompassed maternal age, pregnancy complications, referral delays, inadequate quality of care, and limited health worker competence. Most neonatal deaths occurred within the first 72 hours of life, predominantly among male infants with low birth weight or gestational age under 37 weeks. These findings demonstrate that neonatal mortality results from interconnected medical, maternal, and health system factors that can be systematically identified through AMP-SR. From a policy and practice perspective, strengthening the routine use of AMP-SR findings to inform targeted quality improvement, referral system strengthening, and workforce capacity-building is essential to reduce preventable neonatal deaths in Indonesia.
Volume: 15
Issue: 1
Page: 242-255
Publish at: 2026-03-05

Spatial analysis of stunting risk factors in Central Java, Indonesia: A geographically weighted regression approach (2023 data)

10.11591/ijphs.v15i1.26881
Sylvia Anjani , Faik Agiwahyuanto , Maulana Tomy Abiyasa
The 2022 Indonesian Nutritional Status Survey (SSGI) reported a stunting prevalence of 20.8% in Central Java. Although various studies have examined its risk factors, few have applied a spatial perspective. This study aims to analyze regional variations in stunting risk factors and their contribution to rising stunting rates. This is a quantitative explanatory study employing the geographically weighted regression (GWR) method. Secondary data were obtained from the Central Java Health Profile and Badan Pusat Statistik Indonesia (BPS) in 2023, using a total sampling of 35 districts/cities. The GWR results indicated that chronic energy deficiency (CED; β = 0.0014, p = 0.068) and exclusive breastfeeding (β = 0.0791, p = 0.087) were marginally positively associated with stunting. Low birth weight (LBW) showed a significant positive association (β = 0.1009, p = 0.041), while access to improved sanitation had a strong negative effect (β = -0.1882, p = 0.004). Iron supplementation (≥90 tablets) was not significant (β = -0.0629, p = 0.134), whereas access to improved drinking water was positively and significantly correlated with stunting (β = 0.3778, p = 0.028). These findings contradict existing theories, particularly where higher rates of exclusive breastfeeding and access to clean water are unexpectedly associated with increased stunting in several regions. This suggests the need for further in-depth investigation in those areas to better understand the underlying factors.
Volume: 15
Issue: 1
Page: 179-189
Publish at: 2026-03-05

Factors affecting health-promoting services provision of the sub-district health promoting hospital transferred to mahasarakham provincial administration

10.11591/ijphs.v15i1.26723
Sirimaporn Nassapat , Vorapoj Promasatayapot , Jatuporn Luangub
Hospital services have been transferred to provincial government oversight, making it important to assess the impact of this policy on service quality and efficiency. This study examined factors influencing service delivery at sub-district health-promoting hospitals transferred to the Mahasarakham Provincial Administration in Mahasarakham Province, Thailand. The research was conducted from March 2022 to September 2023 using a mixed-methods approach, including descriptive content analysis for qualitative data. The examined factors were categorized into accessibility, processes, productivity, and outcomes. Data were collected from 500 health workers and 300 patients using questionnaires consisting of six sections with a Likert scale to evaluate perceptions of service quality. Paired t-tests were applied to compare service unit performance before and after the transfer, while one-way ANOVA was used to assess differences among service units. Binary logistic regression identified key factors influencing service quality. The findings revealed a significant relationship between healthcare workers’ attitudes and skills and overall service quality. Units with less than 50% transfer showed minimal improvement, indicating that the extent of transfer strongly influences service outcomes. Despite these differences, the main goal of health promotion remained consistent across units. Effective policy decisions, appropriate management, and stakeholder engagement are essential to improve health outcomes. These findings provide insights for policymakers and administrators to refine health service transfer policies and highlight the need for further research on long-term impacts on service quality and patient outcomes.
Volume: 15
Issue: 1
Page: 216-223
Publish at: 2026-03-05

Evaluating the performance of TAG-IT for prediabetes detection in Indonesian population

10.11591/ijphs.v15i1.26887
Yaltafit Abror Jeem , Rahma Yuantari , Hajar Admira Widiatninda , Russy Novita Andriani , Siti Solichatul Makkiyyah
Early detection of prediabetes plays a critical role in preventing type 2 diabetes mellitus (T2DM), especially within primary care, where access to laboratory testing may be constrained. Non-laboratory-based risk assessment instruments, including the tool to assess the likelihood of fasting glucose impairment (TAG-IT), can facilitate preliminary risk screening. This study sought to determine the diagnostic accuracy of the TAG-IT questionnaire in detecting prediabetes, using the oral glucose tolerance test (OGTT) as the reference standard. A cross-sectional design was implemented across three community health centers in the Special Region of Yogyakarta, Indonesia. Although 308 individuals were initially enrolled, only 93 participants with complete datasets were eligible for final analysis. The discriminative capacity of TAG-IT was evaluated through receiver operating characteristic (ROC) curve analysis along with a contingency table. Among the participants analyzed, 24.7% (23/93) were classified as having prediabetes. The TAG-IT tool exhibited modest discriminatory performance, yielding an AUC of 0.656 (95% CI 0.525-0.786; p = 0.026). Using the identified optimal threshold, sensitivity reached 52.2% while specificity was 67.1%. The negative predictive value was 81.0%, indicating better performance in excluding low-risk individuals. Overall, TAG-IT demonstrated moderate utility as a preliminary screening instrument in primary healthcare, particularly for identifying individuals unlikely to have prediabetes.
Volume: 15
Issue: 1
Page: 32-42
Publish at: 2026-03-05

Effectiveness of delivery mode of pharmacist intervention to improve medication adherence and clinical outcomes in people with depression: a systematic review

10.11591/ijphs.v15i1.25537
Yosi Febrianti , Ika Puspita Sari , Anna Wahyuni Widayanti , Diana Setiyawati
Depression is a treatable mental health condition with various medication options available. For patients with major depressive disorder (MDD), adherence to antidepressants is essential for effective treatment. However, low medication adherence remains a significant challenge, particularly in individuals with depression. Pharmacists play a crucial role in managing these patients. This systematic review evaluated the impact of pharmacist-led interventions, focusing on the effectiveness of delivery modes (in-person vs. online) in improving medication adherence and clinical outcomes for patients with depression. Randomised and non-randomised controlled trials were included. Data were sourced from PubMed, Scopus, ScienceDirect, and Google Scholar using keywords such as "pharmacist intervention," "education," "medication adherence," "depression," and "medication compliance." Three reviewers independently screened and selected articles, and methodological quality was assessed using the Joanna Briggs Institute Randomized Controlled Trial Checklist. From an initial pool of 791 publications, 364 underwent a comprehensive review, and 14 met the inclusion criteria. The most successful interventions were those conducted face-to-face (83%), compared to those conducted through video and phone calls (16%). However, neither method could improve the severity of depression significantly. Pharmacist interventions can enhance patient adherence to antidepressant medication in patients with depression. Compared to virtual methods, face-to-face techniques are more effective at improving adherence. However, they were not able to improve the symptoms of depression.
Volume: 15
Issue: 1
Page: 99-109
Publish at: 2026-03-05
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