Objective: Depression during pregnancy and post-partum is more prevalent in low-middle-income countries (LIMCs). The studies are scarce in these countries, especially in South-East Asia region. The aim of our study was to identify determinants of depression among post-partum mothers. Methods: This cross-sectional study was conducted in 2016 among 347 subjects living in three areas in Jakarta and Bogor city, Indonesia. A mother who gave birth within 4 to 16 weeks was included in this study. The perinatal depression (PND) and its determinant were assessed using a structured questionnaire and Edinburgh Postnatal Depression Scale (EPDS). Logistic regression with the level of significance of <0.05 were employed to measure the association between variables. Result: PND proportion was lower in suburb's area compared to the urban. Mothers who perceived their health status as poor health were more likely to develop PND compared to those who felt that their health is on the prime level (Odds ratio, OR= 3.81, 95 % confidence interval [CI] = 1.7 -8.22, p=0.001). Psychological violence was also strongly correlated to PND. PND had a strong association to mother’s perception of her own health. Conclusion: PND has strong association with mother’s perceived health condition. This result supported previous studies, which suggest that physical health affects depression.

INTRODUCTIONAs the country hardest hit by avian influenza, both in poultry and in human, Indonesia's decision to withhold samples of avian influenza virus A (H5N1) has fired up a global controversy. The objective of this paper is to describe the position taken by Indonesia in the events leading to the decision and in those conducted to resolve the situation.

METHODSThe sources for this paper are the Indonesian human influenza A(H5N1) case reports and study results, summaries, minutes and reports of national and international meetings of virus sharing, and other related Indonesian and WHO documents.

RESULTSThe International Health Regulations 2005 have been applied in different ways based on different interpretations. While one party insists on the importance of free, non-conditional, virus sharing for risk assessment and risk response, Indonesia--as supported by most of the developing countries--stresses on the more basic principles such as sovereignty of a country over its biological materials, transparency of the global system, and equity between developed and developing nations.

CONCLUSIONSThis event demonstrates the unresolved imbalance between the affluent high-tech countries and the poor agriculture-based countries. Regional, global and in-country meetings must continue to be conducted to find solutions acceptable to all.

Animals ; Birds ; Communication ; Cooperative Behavior ; Global Health ; Humans ; Indonesia ; epidemiology ; Influenza A Virus, H5N1 Subtype ; isolation & purification ; Influenza in Birds ; epidemiology ; prevention & control ; transmission ; virology ; International Cooperation ; legislation & jurisprudence ; Risk Factors ; Trust

Objectives: The global prevalence of psychiatric disturbances is rising, detrimentally affecting the quality of care and treatment outcomes for individuals, particularly those with diabetes.This study investigated the association of risk factors for psychiatric disturbances among productive-age patients with diabetes (ages 30−59 years), considering sociodemographic characteristics and co-existing diseases. The risk factors considered included sociodemographic factors (e.g., residence, age, sex, marital status, education, and occupation) and co-existing diseases (e.g., hypertension, heart disease, stroke, renal failure, rheumatism, asthma, and cancer). Methods: This cross-sectional study utilized data from the 2018 Indonesian National HealthSurvey (Riskesdas). The study population comprised respondents aged between 30 and 59years who had diabetes and had completed the 20-question self-reporting questionnaire (SRQ-20). After the exclusion of incomplete SRQ-20 data, the sample included 8,917 respondents.Data were analyzed using logistic regression. Results: Approximately 18.29% of individuals with diabetes displayed symptoms indicative of psychiatric disturbances. After adjusting for sociodemographic factors such as age, sex,education level, occupation, marital status, and place of residence, patients with diabetes who had co-existing conditions such as hypertension, heart diseases, rheumatic disorders, asthma, or cancer had a higher risk for developing psychiatric disturbances than those with diabetes alone (adjusted odds ratio, 6.67; 95% confidence interval, 4.481−9.928; p < 0.001). Conclusion The elevated risk of psychiatric disturbances among patients with diabetes who had comorbidities underscores the importance of addressing mental health issues in the management of diabetes, especially in patients with concurrent disease conditions.

Objectives: Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults. Methods: A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE. Results: A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confidence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was associated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81). Conclusions ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Addressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to elucidate the causal relationships involved and evaluate the effectiveness of targeted interventions.

Objectives: Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults. Methods: A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE. Results: A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confidence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was associated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81). Conclusions ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Addressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to elucidate the causal relationships involved and evaluate the effectiveness of targeted interventions.

Objectives: Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults. Methods: A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE. Results: A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confidence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was associated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81). Conclusions ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Addressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to elucidate the causal relationships involved and evaluate the effectiveness of targeted interventions.

Objectives: Mental health issues have become a growing concern worldwide. Research has shown that regular physical activity (PA) can positively affect mental health. This study investigated the associations between PA and mental health problems (MHPs) in middle-aged Indonesians. Methods: The study utilized data from the 2018 Indonesian Basic Health Research Survey and used a cross-sectional approach. The participants included individuals aged 40-60 years who completed the 20-question Self-Reporting Questionnaire. A logistic regression was performed to analyze a sample of 263 930 data points. Results: Nearly 10.4% of the participants suffered from mental health issues. Notably, among those who did not engage in moderate and vigorous PA, a sign of MHPs was found in 12.5% of participants. Those who met World Health Organization standards for PA were less likely to experience MHPs (10.1%). This study found a significant association between PA and mental health. After adjusting for smoking, alcohol consumption, non-communicable diseases, and socio-demographic variables like age, sex, education, occupation, marital status, and residence, the connection between PA and mental health became even stronger (adjusted odds ratio, 0.81; 95% confidence interval, 0.78 to 0.85; p<0.001). Conclusions Regular PA has been shown to affect mental health positively. Therefore, it is important to improve health education and efforts to raise awareness among middle-aged Indonesians about the importance of PA in maintaining good mental health.

Objectives: The aim of this study was to investigate the relationship between the number of patient comorbidities and the delays in seeking treatment for coronary heart disease (CHD). Methods: This longitudinal study utilized secondary data from the Non-Communicable Disease Risk Factor (NCDRF) cohort study conducted in Bogor City. Individuals who participated in the NCDRF cohort study and were diagnosed with CHD within the 6-year study period met the inclusion criteria. Respondents who were not continuously monitored up to the 6th year were excluded. The final sample included data from respondents with CHD who participated in the NCDRF cohort study and were monitored for the full 6-year duration. The final logistic regression analysis was conducted on data collected from 812 participants. Results: Among the participants with CHD, 702 out of 812 exhibited a delay in seeking treatment. The risk of a delay in seeking treatment was significantly higher among individuals without comorbidities, with an odds ratio (OR) of 3.5 (95% confidence interval [CI], 1.735–7.036; p<0.001). Among those with a single comorbidity, the risk of delay in seeking treatment was still notable (OR, 2.6; 95% CI, 1.259–5.418; p=0.010) when compared to those with 2 or more comorbidities. These odds were adjusted for age, sex, education level, and health insurance status. Conclusion The proportion of patients with CHD who delayed seeking treatment was high, particularly among individuals with no comorbidities. Low levels of comorbidity also appeared to correlate with a greater tendency to delay in seeking treatment.