Abstract Measles has re-emerged as a significant public health threat in Indonesia, signaling gaps in immunization coverage and systemic health inequities. Following the disruptions caused by the COVID-19 pandemic, the country has seen a troubling resurgence in cases. This editorial examines the current epidemiological situation, structural barriers to vaccination, and necessary strategies for elimination. In 2025, Indonesia recorded over 63,000 suspected cases, with the trend continuing into 2026. Current vaccination coverage for children aged 12–23 months stands at 73.46%, which is significantly below the 95% threshold required for herd immunity. Key barriers identified include maternal education levels, archipelagic geography, and sociocultural factors such as religious permissibility and safety concerns. Addressing the measles resurgence requires a multi-faceted approach: strengthening routine and catch-up immunization services, addressing social determinants of health, and rebuilding public trust through community engagement. Achieving high coverage is essential to prevent severe clinical complications and protect vulnerable populations.
Measles ; Measles resurgence ; Immunization coverage ; Indonesia ; Vaccine hesitancy ; Public health systems

Background: Health information systems (HIS) such as Electronic Medical Record (EMR) systems are essential in the integration of fragmented local health systems. Investing in HIS is crosscutting; it can address multiple interrelated health system gaps. However, public health authorities, especially those in resource-constrained communities, are often faced with the dual challenge of upgrading and digitalizing local HIS and addressing other more apparent health system gaps. Objectives: The study aimed to identify and document strategies that not only motivate policy change towards adoption of electronic HIS but also address other health system gaps. Methodology: The author, in his capacity as a local health official in a resource-constrained community, developed, implemented, and documented a social marketing strategy wherein community stakeholders were influenced to invest in an electronic medical record (EMR) system because it was shown to also have the capacity to address other priority health system gaps identified. Results: The strategy, based on situational, stakeholder, and risk analyses, prompted local governance to first invest in improving the delivery of services accredited by the national health insurance program (PhilHealth), for which reimbursements would require electronically submitted claim forms. Community stakeholders then supported the proposal to invest in an EMR system because they were persuaded that it can facilitate increased financing from PhilHealth claims reimbursements, which could be used to enable not only improvement in existing health services but to also initiate other health programs. Conclusion Social marketing using the perspective of health as an investment influenced stakeholders to invest in an EMR system.
Public Health ; Health Information Systems ; Health Communication ; Social Marketing

PURPOSE: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system. METHOD: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively. RESULTS: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination. CONCLUSION ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.
Datasets as Topic ; Delivery of Health Care ; Health Information Systems ; Health Planning ; Humans ; Public Health Surveillance ; methods ; Wounds and Injuries ; prevention & control

OBJECTIVES: Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea. METHODS: Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups. RESULTS: A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a 1°C increase in pneumonia temperature above the threshold of 6°C was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed. CONCLUSIONS: The term ‘pneumonia temperature’ is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.
Aged ; Climate ; Emergencies ; Emergency Service, Hospital ; Humans ; Information Systems ; Korea ; Meteorological Concepts ; Mortality ; Pneumonia ; Public Health ; Seoul ; Weather

OBJECTIVES: The aim of this study is to demonstrate how an integrated information system of mother and toddler cohorts can be developed as a basis of the continuum of care approach that subsequently can be used as the basis of early detection of risk factors of maternal mortality. METHODS: This research was carried out qualitatively. The data was collected through three techniques: in-depth interviews, focus group discussion, and document studies at six public health centers located in four sub-districts of Surabaya, Indonesia. This research was conducted from 2016 to 2018. RESULTS: The data collected from this research has become a basis input data requirement analysis for an integrated mother and toddler cohort information system. The system accommodates all the variables in each period of pre-marriage, pregnancy, labor, infancy and toddlerhood. The system facilitates healthcare workers to retrieve data and information related to mother and toddler health status. CONCLUSIONS: The availability of various pieces of information enables the health status of mothers and toddlers to be monitored thoroughly throughout their long-life cycle. This continuum of care approach is beneficial in the early detection and management of risk factors of maternal mortality, such as pregnancy complications as well as childbirth and postpartum complications.
Cohort Studies ; Continuity of Patient Care ; Delivery of Health Care ; Focus Groups ; Humans ; Indonesia ; Information Systems ; Maternal Mortality ; Maternal-Child Health Services ; Mothers ; Parturition ; Postpartum Period ; Pregnancy ; Pregnancy Complications ; Public Health ; Risk Factors

OBJECTIVES: Conventional radiological processes have been replaced by digital images and information technology systems within South Africa and other developing countries. Picture Archiving and Communication Systems (PACS) technology offers many benefits to institutions, medical personnel and patients; however, the implementation of such systems can be a challenging task. It has been documented that South Africa has been using PACS for more than a decade in public hospitals with moderate success. The aim of this study was to identify and describe the PACS challenges endured by PACS vendors during implementation in the South African public healthcare sector. METHODS: This was achieved by engaging in a methodological approach that was qualitative in nature collecting data through semi structured interviews from 10 PACS experts/participants which were later analysed qualitatively. RESULTS: The findings show that PACS vendors have countless challenges, some of which include space, insufficient infrastructure, image storage capacity, system maturity and vendor related concerns. It was clear that the PACS experts readily offered contextually appropriate descriptions of their encounters during PACS implementations in South African public healthcare institutions. CONCLUSIONS: PACS vendors anticipate these challenges when facing a public healthcare institution and it is recommended that the hospital management and potential PACS stakeholders be made aware of these challenges to mitigate their effects and aid in a successful implementation.
Commerce ; Delivery of Health Care ; Developing Countries ; Health Care Sector ; Hospitals, Public ; Humans ; Information Storage and Retrieval ; Medical Informatics ; Medical Informatics Computing ; Radiography ; Radiology Information Systems ; South Africa

A medical advertisement can include media such as newspapers, magazines, and the Internet. Currently, the Internet is responsible for most medical advertising. Our purpose is to investigate the current status of radiologic images posted on hospitals' websites nationwide, and to evaluate the reliability of online medical advertisements using these images. I investigated the websites of all 1,450 hospitals and 290 oriental medicine clinics nationwide. Specific information on the radiologic images posted was recorded. In terms of body parts, musculoskeletal images account for 78% of the radiologic images on hospitals' websites and 98% of the images for oriental medicine clinics. The purposes for posting radiologic images are to explain the pathophysiology of diseases or the technique of surgical treatments, and to show the effects of hospital-specialized treatments. The most commonly used modalities of radiologic images are plain radiography and MR. More than 90% of the posted images have no source; 10% have no legends; and 5% to 7% have inappropriate legends. In terms of quality, only 60% of the radiologic images on hospitals' websites are rated as acceptable. Fifteen percent of the oriental medicine clinics posted the radiologic images without having a medical doctor on staff. Considering the results, I conclude that it is necessary to re-establish a system of pre-screening and post-evaluation for reviewing hospital websites, especially focusing on the radiologic images posted. Then we can prevent the inappropriate information from influencing or damaging public health, and set up healthy medical competition.
Diagnostic Imaging ; Direct-to-Consumer Advertising ; Health Information Systems ; Human Body ; Internet ; Medicine, East Asian Traditional ; Periodicals ; Periodicals as Topic ; Public Health ; Radiography

OBJECTIVES: We reviewed digital epidemiological studies to characterize how researchers are using digital data by topic domain, study purpose, data source, and analytic method. METHODS: We reviewed research articles published within the last decade that used digital data to answer epidemiological research questions. Data were abstracted from these articles using a data collection tool that we developed. Finally, we summarized the characteristics of the digital epidemiological studies. RESULTS: We identified six main topic domains: infectious diseases (58.7%), non-communicable diseases (29.4%), mental health and substance use (8.3%), general population behavior (4.6%), environmental, dietary, and lifestyle (4.6%), and vital status (0.9%). We identified four categories for the study purpose: description (22.9%), exploration (34.9%), explanation (27.5%), and prediction and control (14.7%). We identified eight categories for the data sources: web search query (52.3%), social media posts (31.2%), web portal posts (11.9%), webpage access logs (7.3%), images (7.3%), mobile phone network data (1.8%), global positioning system data (1.8%), and others (2.8%). Of these, 50.5% used correlation analyses, 41.3% regression analyses, 25.6% machine learning, and 19.3% descriptive analyses. CONCLUSIONS: Digital data collected for non-epidemiological purposes are being used to study health phenomena in a variety of topic domains. Digital epidemiology requires access to large datasets and advanced analytics. Ensuring open access is clearly at odds with the desire to have as little personal data as possible in these large datasets to protect privacy. Establishment of data cooperatives with restricted access may be a solution to this dilemma.
Cell Phones ; Communicable Diseases ; Data Collection ; Dataset ; Epidemiologic Studies* ; Epidemiological Monitoring ; Epidemiology* ; Geographic Information Systems ; Humans ; Information Storage and Retrieval ; Internet ; Life Style ; Machine Learning ; Mental Health ; Methods ; Privacy ; Public Health Surveillance ; Social Media

Spatial epidemiology is a new branch of epidemiology that aims to map the spatial distribution and characteristics as well as to explore the associated influencing factors of diseases by using the geographic information system and other spatial technologies. In recent years, with the rapid development of information-related modern technology, improvement of accessibility on health - related services, natural environment, social and economic big data etc., spatial epidemiology has made considerable progress in both theory and practice and played more important roles in the public health area of China.
China ; Disease ; Epidemiology ; Geographic Information Systems ; Preventive Medicine ; Public Health

The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.
Bias (Epidemiology) ; Classification ; Data Mining ; Decision Support Systems, Clinical ; Delivery of Health Care ; Epidemiology ; Ethics ; Humans ; Learning ; Nephrology ; Propensity Score ; Public Health Surveillance ; Statistics as Topic