Prevalence and associated factors for prehypertension and hypertension among Indonesian adolescents: a cross-sectional community survey

OBJECTIVE

To estimate the prevalence and determine the associated factors for developing prehypertension and hypertension among Indonesian adolescents.

DESIGN

National cross-sectional study.

SETTING

This study was conducted in all the provinces in Indonesia.

PARTICIPANTS

The population in this study were all household members in Basic Health Research 2013 aged 15-19 years. The sample was all members of the 2013 Riskesdas household aged 15-19 years with the criteria of not having physical and mental disabilities, and having complete data. The number of samples analysed was 2735, comprising men (n=1319) and women (n=1416).

MAIN OUTCOME

Dependent variables were prehypertension and hypertension in adolescents based on blood pressure measurements.

RESULTS

The results of the analysis showed that the prevalence of prehypertension in adolescents was 16.8% and hypertension was 2.6%. In all adolescents, the risk factors for prehypertension were boys (adjusted OR, aOR 1.48; 95% CI 1.10 to 1.97), 18 years old (aOR 14.64; 95% CI 9.39 to 22.80), and 19 years old (aOR 19.89; 95% CI 12.41 to 31.88), and obese (aOR 2.16; 95% CI 1.02 to 4.58). Risk factors for hypertension in all adolescents included the age of 18 years old (aOR 3.06; 95% CI 1.28 to 7.34) and 19 years (aOR 3.25; 95% CI 1.25 to 8.41) and obesity (aOR 5.69; 95% CI 2.20 to 14.8). In adolescent girls, the chance of developing prehypertension increased with increasing age and low-density lipoprotein (LDL) cholesterol levels. Several risk factors for hypertension in adolescent boys were age, central obesity and LDL cholesterol levels.

CONCLUSION

This study shows that the trend of prehypertension in adolescents has appeared, besides hypertension. There are distinct patterns of factors that influence it in adolescent girls and boys, which can be useful to sharpen of planning and implementing health programmes.

Factors associated with measles antibody titers in children aged 12-36 months in Indonesia: an analysis of National Health Research 2013

Background: The immunization program in Indonesia has been implemented since 1956 started to eradicate smallpox and expanded until 1980, including Measles. The timely and complete implementation of basic immunization is the main strategy to protect the population, including outbreak prevention. The purpose of this study is to determine the level immunity of Measles antibody as the outcome of completed basic immunization and its contributors in children aged 12-36 months. Methods: This study is a secondary data analysis of the Indonesia Basic Health Survey (RISKESDAS) 2013. The analysis was carried out on a serological sample of the antibody titer of children aged 12-36 months, totaling 229 samples. The sample inclusion criteria were children who had complete sociodemographics data, basic immunization records and Measles antibody titer data. Measles examination was carried out using the Enzyme-Linked Immunosorbent Assay (ELISA) method.   Results: Incomplete immunization, being a boy, and lack of cleanliness in the family room were significantly associated with lower measles antibody levels in children. Having each variable controlled, completeness of immunization (OR=1,99; p=0.018; 95% CI=1.124-3.544) and gender of boy (OR=2.0; p=0.016; 95% CI=1.137-3.515) remain as significant variables for antibody’s titer. Conclusion: The completeness of immunization has a significant association towards titer antibody of Measles in children. Immunization completeness is an actual effort to reach herd immunity in children and to prevent measles outbreak in the community. Adequate health promotion is needed to change people's behavior to believe in the safety and importance of implementing complete basic immunization for children even in pandemic conditions. Keywords: antibody titer, immunization, children aged 12-36 months, Indonesia, measles   Abstrak Latar belakang: Program imunisasi di Indonesia telah dilaksanakan sejak tahun 1956 yang dimulai dengan pemberantasan cacar yang diperluas hingga tahun 1980, termasuk campak. Pelaksanaan imunisasi dasar yang tepat waktu dan lengkap merupakan strategi utama untuk perlindungan penduduk, termasuk pencegahan Kejadian Luar Biasa (KLB). Tujuan dari penelitian ini untuk mengetahui tingkatan kekebalan antibodi Campak sebagai hasil dari kelengkapan imunisasi dasar dan faktor yang berkontribusi pada anak usia 12-36 bulan. Metode: Penelitian ini merupakan analisis data sekunder Riset Kesehatan Dasar Indonesia (RISKESDAS) 2013. Analisis dilakukan pada sampel serologi titer antibodi anak usia 12-36 bulan yang berjumlah 229 sampel. Kriteria inklusi sampel adalah anak yang memiliki data sosiodemografi lengkap, catatan imunisasi dasar dan data titer antibodi Campak. Pemeriksaan campak dilakukan dengan metode Enzyme-Linked Immunosorbent Assay (ELISA). Hasil: Imunisasi yang tidak lengkap, berjenis kelamin laki-laki, dan kurangnya kebersihan di ruang keluarga berhubungan bermakna dengan rendahnya tingkat antibodi campak pada anak. Setelah masing-masing variabel terkontrol, kelengkapan imunisasi (OR=1,99; p=0,018; 95% CI=1.124-3.544) dan jenis kelamin laki-laki (OR=2.0; p=0.016; 95% CI=1.137-3.515) merupakan variabel yang tetap berhubungan dengan titer antibodi secara signifikan. Kesimpulan: Kelengkapan imunisasi memiliki hubungan yang bermakna terhadap titer antibodi Campak pada anak. Kelengkapan imunisasi merupakan upaya nyata untuk mencapai herd immunity pada anak dan mencegah wabah campak di masyarakat. Promosi kesehatan yang memadai diperlukan untuk mengubah perilaku masyarakat agar percaya akan keamanan dan pentingnya pelaksanaan imunisasi dasar lengkap bagi anak meskipun dalam kondisi pandemi. Kata kunci: titer antibodi, imunisasi, anak usia 12-36 bulan, Indonesia, campak

Associations Between Parental Depression and Early Childhood Development in Indonesia: A Cross-sectional Study

Objectives

This study aimed to determine the associations between parental depression and early childhood development among children aged 36 months to 59 months in Indonesia.

Methods

From Indonesia’s Basic Health Survey (RISKESDAS) 2018, this study included 6433 children aged 36 months to 59 months and their parents. Maternal and paternal depression was examined using the Mini International Neuropsychiatric Interview survey instrument, which was previously translated into Indonesian. The study also used the Early Child Development Index to measure child development and its 4 domains (cognitive, physical, socio-emotional, and learning). Multivariate logistic regression analysis was performed to determine the association between parental depression and early childhood development.

Results

Overall, 10.3% of children aged 36 months to 59 months were off-track for development. After adjusting for biological, parental, and social characteristics, children born to parents with depression were found to be 4.72 times more likely to be off-track for development (95% confidence interval, 1.83 to 12.15).

Conclusions

Children of depressed parents were more likely to be off-track for development. The findings highlight the need for early diagnosis and timely intervention for parental depression to promote early childhood development.

How Well Does Body Mass Index (BMI) Predict Undiagnosed Hypertension and Diabetes in Indonesian Adults Community Population?

BACKGROUND: Previous studies have reported that Body Mass Index (BMI) cut-off was related to non-communicable diseases. This study aimed to give the latest evidence related to the accuracy of BMI cut-off towards undiagnosed hypertension and diabetes in the Indonesian population. METHODS: This was A cross-sectional study that involved data of the 2018 national population-based health survey, with the samples were 15,516 male and female populations aged between 19 years old and above. This study only included those claimed to have never been diagnosed as suffering from diabetes and hypertension by health workers. Receiver operating characteristic (ROC) analysis was conducted to assess the optimal BMI cut-off. The logistic regression was performed to assess the association of BMI on undiagnosed hypertension and diabetes controlled by several variables. RESULTS: The average BMI sample was 24 kg/m2 (SD = 4.6 kg/m2. The proportion of undiagnosed hypertension was 36.9%, and 12.3% for the proportion of undiagnosed diabetes. According to the ROC, the result shows BMI was more sensitive to hypertension conditions compared to diabetes. BMI cut-off points at 23.9 kg/m2 (AUC=0.59;Se=64.3%;Sp=53.4%) was the optimum value to predict hypertension and 24.9 kg/m2 (AUC=0.55;Se=53.1%;Sp=56.4%) was the optimum for diabetes. CONCLUSIONS: Based on the optimal AUC cut-off points for BMI which is around 0.5, BMI needs to be reconsidered as an anthropometric index in predicting undiagnosed hypertension and diabetes. And an assessment can be made using other anthropometric indices, such as waist circumference to predict undiagnosed hypertension and diabetes.

Factors Affecting Public Non-compliance With Large-scale Social Restrictions to Control COVID-19 Transmission in Greater Jakarta, Indonesia

OBJECTIVES

The Indonesian government issued large-scale social restrictions (called Pembatasan Sosial Berskala Besar, or PSBB) at the beginning of the coronavirus disease 2019 (COVID-19) pandemic to control the spread of COVID-19 in Jakarta, Bogor, Depok, Tangerang, and Bekasi (Greater Jakarta). Public compliance poses a challenge when implementing large-scale social restrictions, and various factors have contributed to public non-compliance with the regulation. This study aimed to determine the degree of non-compliance and identify the factors that contributed to public non-compliance with the PSBB in Greater Jakarta, Indonesia.

METHODS

This was a quantitative study with a cross-sectional design. A total of 839 residents of Greater Jakarta participated in this study. Data were collected online using a Google Form, and convenience sampling was undertaken. Univariate and multivariate analyses were performed to explore the relationships between public non-compliance with the PSBB regulation and socio-demographic variables, respondents' opinion of the PSBB, and social capital.

RESULTS

A total of 22.6% of subjects reported participating in activities that did not comply with the PSBB. The variables that most affected non-compliance with the PSBB were age, gender, income, opinion of the PSBB, and social capital.

CONCLUSIONS

Strengthening social capital and providing information about COVID-19 prevention measures, such as washing one's hands with soap, wearing masks properly, and maintaining social distancing, is essential. Robust public understanding will foster trust and cooperation with regard to COVID-19 prevention efforts and provide a basis for mutual agreement regarding rules/penalties.

Dampak Depresi Parental Terhadap Kejadian Stunting di Indonesia

Abstract Stunting conditions can cause cognitive damage in children. The risk of children experiencing chronic malnutrition, such as stunting, is increasing with the lack of care due to depression experienced by parents. This study aims to look at the effect of parental depression on the incidence of stunting in Indonesia. The data used is the Indonesia Family Life Survey (IFLS), which is a longitudinal survey with 83 percent representation of the entire population in Indonesia. The data used are IFLS4 and IFLS5, which are two survey waves, 2007/2008 and 2014/2015. The unit of analysis is children aged 0-59 months who live with parents and have complete information about height measurements, with a total sample of 2,224 children at IFLS4 and followed up to IFLS5. Depression information was obtained based on the 10-question Center for Epidemiological Studies Depression instrument (CESD-10) asked of parents. While stunting is assessed based on the results of measurements of height according to age in children. The control variables examined included the type of residence, maternal age at birth, maternal education, employment status, economic status, sanitation, maternal height, childbirth weight, child sex, and birth order. The effect of parental depression on the incidence of stunting was analyzed using panel logistic regression method with random effects. The results showed that maternal depression (OR 0.89; 95% CI: 0.65-1.24) and paternal depression (OR 0.87; 95% CI: 0.63-1.21) did not significantly influence the incidence of stunting. The likelihood of stunting is higher among children in rural areas, have inadequate sanitation, low birth weight, and are the third child. Further research is needed regarding parental depression with uniform instruments. Keywords: paternal depression, maternal depression, stunting, malnutrition Abstrak Kondisi stunting dapat menyebabkan terjadinya kerusakan kognisi pada anak. Risiko anak mengalami malnutrisi kronis seperti stunting semakin meningkat dengan kurangnya pengasuhan akibat depresi yang dialami oleh orang tua. Penelitian ini bertujuan melihat pengaruh depresi parental terhadap kejadian stunting di Indonesia. Data yang digunakan adalah data Indonesia Family Life Survey (IFLS) yaitu survei longitudinal dengan keterwakilan 83 persen dari seluruh populasi di Indonesia. Data yang digunakan adalah IFLS4 dan IFLS5 yang merupakan dua wave survei pada tahun 2007/2008 dan 2014/2015. Unit analisis adalah anak usia 0-59 bulan yang tinggal bersama orangtua serta memiliki informasi lengkap tentang pengukuran tinggi badan dengan total sampel 2.224 anak pada IFLS4 dan diikuti sampai IFLS5. Informasi depresi diperoleh berdasarkan instrumen Center for Epidemiological Studies Depression versi 10 pertanyaan (CESD-10) yang ditanyakan kepada orangtua. Sedangkan stunting dinilai berdasarkan hasil pengukuran tinggi badan menurut umur pada anak. Variabel kontrol yang diteliti antara lain tipe daerah, usia ibu saat melahirkan, pendidikan ibu, status pekerjaan, status ekonomi, sanitasi, tinggi ibu, berat lahir anak, jenis kelamin anak dan urutan kelahiran anak. Pengaruh depresi parental terhadap kejadian stunting dianalisis menggunakan metode regresi logistik panel dengan efek random. Hasil penelitian menunjukkan depresi maternal (OR 0,89; 95% CI: 0,65-1,24) dan paternal (OR 0,87; 95% CI: 0,63-1,21) tidak berpengaruh secara bermakna terhadap kejadian stunting. Peluang terjadinya stunting lebih tinggi pada anak di perdesaan, memiliki sanitasi yang tidak layak, berat badan lahir rendah dan merupakan anak ketiga. Perlu adanya penelitian lebih lanjut mengenai depresi parental dengan instrumen yang seragam. Kata kunci: depresi paternal, depresi maternal, stunting, malnutrisi

Adolescents school students in Java and Sumatra are in greater risk of obesity

Latar belakang: Indonesia masih menghadai beban ganda masalah gizi berkaitan dengan obesitas yang meningkat sementara masalah kurang gizi masih terjadi, termasuk pada remaja. Hasil penelitian masih terbatas, dalam hal aspek demografi dan geografi di Indonesia, sementara strategi pencegahan obesitas pada remaja membutuhkan intervensi yang lebih optimal. Tujuan: Studi ini bertujuan untuk memberikan gambaran masalah obesitas berdasarkan karakteristik populasi dan perilaku berisiko di region yang berbeda. Metode: Studi ini menggunakan data sekunder dari survei kesehatan berbasis sekolah tahun 2015 yang dikembangkan oleh CDC Amerika dan WHO, dengan modifikasi sesuai kondisi Indonesia. Analisis mencakup 10,544 pelajar kelas 7 – 12 dengan representasi populasi nasional di tiga regional/pulau di Indonesia. Uji statistik yang digunakan adalah chi-square dan log regression. Hasil: Model logistik menunjukkan pelajar remaja yang tinggal di pulau Jawa mempunyai risiko yang lebih tinggi untuk mengalami obesitas (adjusted OR 2.1;95%CI 1.3-3.3) dibandingkan pada pelajar yag tinggal di pulau Sumatra dan luar pulau Jawa dan Sumatra, sementara perilaku berisiko seperti aktivitas fisik dan perilaku diet tidak menunjukkan hubungan yang bermakna dengan kejadian obesitas. Kesimpulan: Disparitas masalah obesitas terjadi pada remaja di tiga pulau besar di Indonesia, di tingkat kelas yang berbeda dan perilaku diet berisiko yang berbeda. Strategi pencegahan diperlukan lebih mengarah pada intervensi berbasis sekolah dengan memperhatikan faktor geografis tempat tinggal di pulau Sumatra dan lainnya serta tingkat atau kelas yang berbeda. (Health Science Journal of Indonesia 2019;10(2):119-27) Kata kunci: Obesitas, remaja, perilaku diet, region, aktivitas fisik   Abstract Background: Indonesia faces burden of nutrition related diseases as obesity is increasing while malnutrition still exists, including in adolescents. Research are limited in term of which specific demography and geography aspects in Indonesia while stronger strategic intervention to prevent obesity in adolescents is needed. Objective: This study aims to describe proportion of obesity in indifferent adolescents characteristic and eating behaviour in different regions. Method: This study used data from Indonesia 2015 Global School-based Health Survey developed by US CDC and WHO) with modification based on Indonesia specific. The analysis included 10,544 students covered national representative and three regions of school students (grade 7 to 12) in Indonesia. Statistical analysis used chi square and log regressions. Results: The logistic model showed adolescents students living in Java island has significantly higher risk of obesity (adjusted OR 2.1;95%CI 1.3-3.3) compare to their peers in outside Java and Sumatra Island, while behavior risk factors such as physical activity and dietary habit were not significantly associated with obesity. Conclusions: Issues disparity of obesity in adolescents occurred in the three main Islands in Indonesia, in different school grades and in those with different dietary risk behaviours. Intervention strategy to address adolescents obesity issues will need to be directed toward school-based settings with taking into account specific approaches for students in Sumatra and other main islands in Indonesia as well as specific for junior and senior high school. (Health Science Journal of Indonesia 2019;10(2):119-27). Keywords: Obesity, adolescents, dietary behaviour, region, physical activity