Background: Indonesia is amongst the top 10 countries with the highest prevalence of Type 2 Diabetes Mellitus (T2DM) at 10.8%. However, the distinguishable features of T2DM in Indonesia remain obscure. Therefore, the DISCOVER study aimed to describe the characteristics of T2DM patients, associated vascular complications and treatment in Indonesia. Methodology: DISCOVER study is a multi-country, multicenter, prospective, cohort study over 3 years. In the present study, the data were collected from 13 sites from clinical practice, hospitals and public health facilities in Indonesia. Results: A total of 221 subjects were recruited with a mean age of 55.6 ± 9.8 years and body mass index (BMI) of 26.4 ± 4.4 kg/m2. Over 40% of patients had hypertension and/or hyperlipidemia. The mean duration of T2DM was 58.3 ± 62.0 months while the mean HbA1c levels was 9.2 ± 2%. In total, 82.4% completed the study within a 36-month follow-up period. BMI remained elevated i.e., >25 kg/m2. A significant reduction was observed in HbA1c levels as compared to baseline (9.2 ± 2% to 8.1 ± 1.8%). T2DM-associated microvascular complications such as peripheral neuropathy, albuminuria and chronic kidney disease were observed in 17.2%. Macrovascular complications including coronary artery disease and heart failure were seen in 26.2% of patients. We also found that more than 70% of patients were on metformin and/or sulfonylurea. Conclusion The features of patients with T2DM in Indonesia were high BMI, with hypertension and hyperlipidemia as co-morbidities. Metformin and sulfonylureas were the most common treatment. HbA1c reduction during follow-up did not reach recommended target. Thus, early detection and intervention using available glucose-lowering medications and aggressive management of risk factors and complications are essential to improve outcomes of diabetes management in Indonesia.
diabetes type 2 ; vascular complications ; Indonesia

Introduction: Depression is one of the mental illnesses that affect adolescents worldwide. This study analysed the factors associated with depressive symptoms among adolescents in Indonesia. Methods: A quantitative cross-sectional study was conducted using secondary data from the Indonesian Family Life Survey 2014. The sample included 3,603 adolescents aged 10-19 years. Data were analysed using logistic regression statistical tests. Results: Of the adolescents, 29.1% had depressive symptoms. The bivariate analysis showed that sex, region, economic status, chronic illness history, sleep quality, smoking habit, and personality type were associated with a higher probability of depressive symptoms among the adolescents. Conclusion A history of chronic diseases contributes the most to the occurrence of depressive symptoms among adolescents. To reduce the prevalence of chronic diseases associated with depression, the Indonesian government must make preventive efforts through early detection among young people.
Depression ; Adolescent ; Indonesia

Introduction: This study aimed to evaluate the prevalence of frailty and its determinants, especially in relation to chronic disease and lifestyle among elderly individuals. Methods: A cross-sectional study was conducted among 278 individuals aged 60 years and over living in Jakarta. All participants underwent assessment, including medical history-taking, physical examination and blood tests for the sugar level and lipid profile. Frailty was assessed using the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe. All data were analysed using the chi-square test and multinomial logistic regression analysis. Results: The prevalence of pre-frailty and frailty among the older adults was 40.6% and 28.8%, respectively. Female sex, lack of exercise, presence of cardiovascular diseases and high low-density lipoprotein cholesterol (LDL-C) level were associated with pre-frailty and frailty. Education for <9 years was associated only with frailty. After adjustments for all covariates, female sex (adjusted odds ratio [AOR]=1.96, 95% confidence interval [CI]=1.07–3.60; AOR=3.93, 95% CI=1.87–8.24), lack of exercise (AOR=14.81, 95% CI=5.07–43.26; AOR=49.48, 95% CI=16.20–151.09) and presence of cardiovascular diseases (AOR=5.32, 95% CI=1.40–19.20; AOR=6.06, 95% CI=1.63–22.56) were associated with pre-frailty and frailty. Meanwhile, education for <9 years (AOR=1.97, 95% CI=1.05–3.69) and high LDL-C level (AOR=3.52, 95% CI=1.14–10.88) were associated with frailty. Conclusion Exercise, early screening and intervention for cardiovascular diseases and maintenance of lower LDL-C levels may prevent and slow the progression of frailty.
Frailty ; Aged ; Aging ; Cardiovascular Diseases ; Exercise ; Indonesia

Aims: The aim of this study was to screen lactic acid bacteria (LAB) isolates with probiotic properties for tilapia (Oreochromis niloticus) from the intestines of mackerel and to analyze its ability to produce hydrolase enzymes (amylase, protease, cellulase and lipase). Methodology and results: Ten samples of mackerel were collected from the Fish Auction Place, Lewoleba, Nubatukan District, Lembata Regency, East Nusa Tenggara Province, Indonesia. The process for screening were antimicrobial activity, pH tolerance test of 1, 3 and 5, bile salt concentrations of 2.5%, 5% and 7.5%, and water salinity (0.5%, 3.5% and 6.5%). The autoaggregation and semi-qualitative test of hydrolase enzymes were also carried out. In total, 21 LAB isolates were derived from mackerel intestines. Isolates that have the stronger ability to inhibit the pathogen Aeromonas hydrophila ATCC 7966 are KBP 3.3, KBP 3.3.1 and KBP 6.3, while KBP 1.3, KBP 1.1.1 and KBP 3.3.1 were able to inhibit Streptococcus agalactiae ATCC 13813. The LAB isolates that survived at the tested pH were KBP 3.3.1, KBP 3.3, KBP 1.1.1 and KBP 1.3. Results also suggest that the four isolates were tolerant to bile salt concentrations and water salinity with good survival rates (>94.7%) and had proteolytic, lipolytic and cellulolytic activities. The isolates KBP 3.3, KBP 3.3.1 and KBP 1.1.1 were identified as Weissella confusa 6250, while the isolate KBP 1.3 was identified as W. confusa C5-7. Conclusion, significance and impact of study The characteristics of four selected isolates indicate their potential as a probiotic. These potential probiotic isolates can be applied directly to fish by utilizing microencapsulation technology or adding to the feed.
Lactobacillales ; Perciformes ; Indonesia

The present study aimed to regulate the market circulation of Caryophylli Flos and formulate standards for commodity specifications and grades of Caryophylli Flos. Market survey was carried out in four major medicinal material markets with 48 samples of Caryophylli Flos collected. The property, 100-seed weight, impurity percentage, moisture, and eugenol content in Caryophylli Flos of different specifications from different producing areas were determined and analyzed. The results showed that 27.1% of the samples surveyed on the markets did not meet the requirements of Chinese Pharmacopoeia(2020 edition). The 100-seed weight and the property are important factors for the classification of Caryophylli Flos specifications. There were significant differences in the property, 100-seed weight, impurity percentage, and eugenol content in Caryophylli Flos samples of different specifications from different producing areas, and also differences in the proportions of different specifications in Caryophylli Flos samples from different producing areas. The African-originated Xiaohong(medium grade) and Guangxi-originated Xiaohong(medium grade) accounted for 70% and 66.7% respectively, the Indonesian-originated Dahong(top grade) for 56.2%. In conclusion, there are many problems in the circulation of Caryophylli Flos at present, mainly including the loss of origin information, no standards for specifications, non-implementation of grade standards, excessive impurities, and no evidence for authenticity identification. According to the classification of Caryophylli Flos specifications in this study, the average eugenol content of Xiaohong is significantly higher than the Dahong by 4.74%.
China ; Drugs, Chinese Herbal/analysis* ; Indonesia

OBJECTIVE: The prevalence of complementary and alternative medicine (CAM) usage among patients with type 2 diabetes mellitus (T2DM) in Indonesia is high. However, to date, little is known about why Indonesian T2DM patients choose CAM therapies, how their knowledge, attitude and practice (KAP) of CAM affects their choices, or how demographics correlate with patient choices. Therefore, this study aimed to investigate the KAP and predictors of CAM usage in T2DM patients in Indonesia. METHODS: This was an observational, cross-sectional study. Patients were interviewed using a questionnaire. Chi-square tests or Fisher's exact tests were used to compare demographic and clinical data, as well as KAP assessments, between T2DM patients who use and do not use CAM. Multivariate logistic regression analyses were used to investigate predictors of CAM usage. RESULTS: A total of 628 T2DM patients were enrolled in the study. CAM therapies were used by 341 patients (54.3%). The most common therapies were herbs and spiritual healing, used by 100.0% and 68.3% of CAM-using patients, respectively. CAM therapies were frequently recommended by family members (91.5%), and CAM users had significantly more knowledge and more positive attitudes toward CAM therapies than nonusers. Among users, 66% said they would not follow their healthcare providers' instructions to not use CAM therapies, and 69.5% said they would not disclose their plan to use CAM therapies with their healthcare provider. Neither demographic nor clinical characteristics were associated with CAM use. The factors that best predicted the use of CAM therapies were their availability and low cost (odds ratio [OR] = 4.59; 95% confidence interval [CI]: 3.01-7.01), the belief that CAM therapies were safe (OR = 2.04; 95% CI: 1.40-2.95), the belief that CAM therapies could help with diabetes control (OR = 1.75; 95% CI: 1.15-2.66), and the belief that CAM therapies could help maintain physical health (OR = 1.68; 95% CI: 1.13-2.49). CONCLUSION CAM therapy users were more knowledgeable and had more positive attitudes toward CAM, but most of them chose not to disclose their CAM use to their healthcare providers. CAM use in Indonesia was associated with its accessibility, affordability, safety and effectivity, but not with any demographic or clinical characteristics. This study provided new evidence and insights for nurses and physicians in Indonesia that will help to design educational programs about the safety and efficacy of CAM therapies.
Complementary Therapies ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/therapy* ; Health Knowledge, Attitudes, Practice ; Humans ; Indonesia ; Surveys and Questionnaires

The decline in birth rates has become a very serious problem in various parts of the world. Many countries have implemented national programs for increasing birth rates, one of which involves the use of traditional medicine as an alternative solution. Among the fast-growing traditional medicines, traditional Chinese medicine (TCM) and traditional Indonesian medicine (TIM) have attracted a lot of demand globally. Here, we analyzed and compared the herbal medicines from TCM and TIM that must be avoided by pregnant women for preventing miscarriage and maintaining safety during pregnancy and the postpartum period. This review uses data from official reports from the respective government and national and international electronic databases for analysis. Although TCM and TIM have their own characteristics of treatment, they also have some similarities in concept and treatment, especially those related to herbal medicines. This review can be used as a reference base to help pregnant women consume herbal medicines at appropriate conditions and doses.
Drugs, Chinese Herbal/therapeutic use* ; Herbal Medicine ; Humans ; Indonesia ; Medicine, Chinese Traditional ; Plants, Medicinal ; Pregnancy

BACKGROUND: Previous studies have suggested that exposures to heavy metals (arsenic, cadmium, lead, and selenium) may be associated with differences in blood pressure. However, the findings of these studies have been inconsistent. This study was performed to examine the associations between urinary heavy metal concentrations and blood pressure among residents of four Asian countries (Bangladesh, Indonesia, Nepal, and Vietnam). METHODS: This cross-sectional study examined 1899 adults in four Asian countries. Urinary concentrations of heavy metals were measured by inductively coupled plasma mass spectrometry. A questionnaire survey was administered regarding individual characteristics. Anthropometric measurements (height and weight) were performed. Systolic and diastolic blood pressures were measured after a short rest. Multiple linear regression models were applied to investigate associations between urinary heavy metal concentrations and blood pressure after adjustments for age, sex, and body mass index. RESULTS: The geometric means of the urinary concentrations of arsenic, cadmium, lead, and selenium were 84.6, 0.885, 2.09, and 16.5 μg/g creatinine, respectively. The urinary arsenic concentrations were slightly higher than those typically reported in non-polluted populations, while urinary cadmium, lead, and selenium concentrations were equivalent or slightly lower. The urinary lead concentrations were positively associated with both systolic and diastolic blood pressure, but urinary selenium concentrations were negatively associated with them. CONCLUSIONS Variations in the urinary concentrations of lead and selenium were associated with blood pressure at low levels of exposure/intake.
Adult ; Arsenic/urine* ; Bangladesh ; Blood Pressure ; Cadmium/urine* ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Indonesia ; Lead/urine* ; Linear Models ; Male ; Metals, Heavy/urine* ; Middle Aged ; Nepal ; Selenium/urine* ; Vietnam

OBJECTIVES: To study the association between milk consumption and lactose malabsorption in Indonesian children aged 3-12 years. METHODS: This cross sectional study was conducted in randomly selected presumed healthy children with good nutritional status aged 3-12 years in Central Jakarta, Indonesia ( RESULTS: The prevalence of lactose malabsorption in children aged 3-5 years and children aged 6-12 years was 20.8% (15/72) and 35.3% (36/102), respectively. There was no association between milk or milk product consumption and lactose malabsorption ( CONCLUSIONS There is no association between milk consumption and lactose malabsorption in Indonesian children aged 3-12 years, suggesting that genetic predisposition may be more important than adaptive mechanisms to lactose consumption.
Animals ; Breath Tests ; Child ; Cross-Sectional Studies ; Humans ; Indonesia/epidemiology* ; Lactose Intolerance/epidemiology* ; Milk

The demographic transition occurs all over the world, including Indonesia. The Indonesian Ministry of Health announced that Indonesia has been dominated by an aging society since 2017. The proportion of elderly has reached 9.03%. This commentary study aimed to see the general conditions of healthcare providers (primary healthcare centers and hospitals) in facing the aging society. Results showed that the primary healthcare centers and public hospitals are not ready yet to face the aging society. In fact, primary health care is not friendly to the elderly in terms of the facilities and the limited services of home visits. This study recommended the government and stakeholders to provide the optimal quality and quantity of health care services to the elderly who have dominated the population.
Hospitals ; Indonesia